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Kansas 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
$1,361.00 / $3,506.00 / $10,439.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$76.69 / $85.14 / $128.90
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.16 / $141.36 / $151.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$330.00 / $330.00 / $330.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.78 / $127.31 / $155.13
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$82.31 / $122.40 / $2,819.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.02 / $116.12 / $758.33
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$191.00 / $550.00 / $1,769.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.02 / $112.34 / $147.44