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Mississippi 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
$81.31 / $784.00 / $1,831.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$76.01 / $117.78 / $179.61
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.00 / $154.00 / $154.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.40 / $127.21 / $177.56
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $32.34
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$225.00 / $513.00 / $1,581.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.81 / $102.13 / $230.56