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Virginia 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 $1,175 · 10th–90th $91–$7,0790%5%10%10th90th$1,175Professionalmedian $98 · 10th–90th $76–$1700%10%10th90th$98$50.0$200.0$1.0K$5.0K

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
$95.50 / $2,570.40 / $7,079.46
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $91.20 / $131.83
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $120.23 / $173.78
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $104.71 / $954.99
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $151.36 / $151.36
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $109.65 / $177.83
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $117.49 / $141.25
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $165.96
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $107.15 / $173.78
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $77.62 / $77.62
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $117.49 / $4,073.80
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $128.82 / $4,073.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $1,047.13 / $2,344.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $102.33 / $173.78