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Delaware 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
$3,235.94 / $3,235.94 / $7,244.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.62 / $120.23 / $251.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $91.20 / $134.90
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$501.19 / $501.19 / $501.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.18 / $100.00 / $213.80