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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
$81.28 / $954.99 / $1,995.26
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.44 / $85.11 / $165.96
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.88 / $154.88 / $154.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.13 / $125.89 / $177.83
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $33.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$338.84 / $575.44 / $1,513.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.62 / $97.72 / $169.82