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Hawaii 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 $2,884 · 10th–90th $1,000–$2,8840%50%10th$2,884Professionalmedian $123 · 10th–90th $72–$3,0900%10%10th90th$123$20.0$100.0$500.0$2.0K

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
$1,000.00 / $2,884.03 / $2,884.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $83.18 / $158.49
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $120.23 / $144.54
HMSA
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $138.04 / $165.96
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $114.82 / $144.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,071.52 / $1,071.52
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $112.20 / $131.83
University Health Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $1,548.82 / $3,981.07