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Connecticut 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)

Facilitymedian $4,571 · 10th–90th $182–$8,5110%10%20%10th90th$4,571Professionalmedian $105 · 10th–90th $71–$2190%10%10th90th$105$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

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
$181.97 / $4,570.88 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $97.72 / $223.87
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,311.31 / $3,801.89 / $4,786.30
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $141.25 / $199.53
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $134.90 / $229.09
ConnectiCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $112.20 / $112.20
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,288.25 / $3,981.07 / $7,079.46
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $112.20 / $190.55