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New Mexico 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 $158 · 10th–90th $98–$7,7620%10%20%10th90th$158Professionalmedian $120 · 10th–90th $79–$2190%10%10th90th$120$20.0$100.0$500.0$2.0K

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 / $162.18 / $7,762.47
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $114.82 / $239.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $117.49 / $158.49
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$27.54 / $33.11 / $138.04
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$74.13 / $109.65 / $158.49
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $125.89 / $173.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $1,148.15 / $1,412.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $131.83 / $173.78