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Georgia 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
$141.25 / $3,630.78 / $7,413.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.44 / $89.13 / $169.82
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$588.84 / $1,258.93 / $1,584.89
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.28 / $107.15 / $169.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.44 / $97.72 / $186.21
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $114.82 / $245.47
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.82 / $131.83 / $144.54
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$354.81 / $1,513.56 / $2,511.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.18 / $117.49 / $223.87