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Utah 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

Facilitymedian $3,715 · 10th–90th $912–$6,0260%10%10th90th$3,715Professionalmedian $851 · 10th–90th $676–$1,6600%10%20%10th90th$851$50.0$200.0$1.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$912.01 / $3,388.44 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $812.83 / $1,659.59
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,071.52 / $1,380.38
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $3,019.95
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,248.07 / $7,244.36 / $10,964.78
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $1,148.15 / $1,862.09
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $1,071.52 / $1,621.81
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $1,122.02 / $1,949.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $5,128.61 / $8,317.64
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $831.76 / $1,258.93