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Maine 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)

Professionalmedian $107 · 10th–90th $72–$1950%10%10th90th$107$50.0$100.0$200.0$500.0

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
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $97.72 / $194.98
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $120.23 / $169.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $125.89 / $213.80
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $125.89 / $204.17
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $89.13 / $131.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $128.82 / $194.98