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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
$82.64 / $2,800.00 / $6,915.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$76.69 / $91.46 / $170.64
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$552.38 / $848.40 / $1,789.93
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.78 / $121.65 / $214.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.04 / $98.34 / $184.81
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$96.89 / $104.70 / $248.15
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$119.70 / $143.06 / $167.35
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$353.00 / $1,580.00 / $2,665.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.81 / $122.42 / $223.41