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Colorado rates for HCPCS 15136

Dermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$915.00 / $3,889.00 / $9,872.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.17 / $90.02 / $119.99
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.38 / $124.40 / $193.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.46 / $111.89 / $146.68
Denver HMP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$90.02 / $113.87 / $144.03
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$94.89 / $131.90 / $187.88
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$730.00 / $1,464.00 / $3,011.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.05 / $130.18 / $197.11