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Indiana 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 $2,188 · 10th–90th $102–$5,6230%5%10%10th90th$2,188Professionalmedian $89 · 10th–90th $72–$2000%10%20%10th90th$89$50.0$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
$120.23 / $3,801.89 / $5,623.41
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $85.11 / $208.93
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $2,187.76 / $3,388.44
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $107.15 / $165.96
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $91.20
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $117.49 / $194.98
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $104.71 / $154.88
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $2,290.87 / $7,413.10
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $95.50 / $158.49