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Tennessee rates for HCPCS 15135

Dermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less, or 1% of body area of infants and children

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$758.58 / $2,290.87 / $4,073.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616.60 / $758.58 / $1,230.27
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,949.84 / $4,073.80 / $5,888.44
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $1,071.52 / $1,698.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $1,000.00 / $2,238.72
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,220.18 / $11,220.18 / $28,840.32
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,309.57 / $7,413.10 / $7,413.10
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,754.23 / $4,570.88 / $7,585.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $870.96 / $1,548.82