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Wisconsin 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 $1,148 · 10th–90th $79–$3,9810%5%10%10th90th$1,148Professionalmedian $123 · 10th–90th $74–$3160%10%10th90th$123$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
$72.44 / $177.83 / $1,905.46
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $89.13 / $218.78
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,041.74 / $2,630.27 / $6,165.95
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $186.21 / $416.87
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $288.40 / $457.09
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $154.88 / $257.04
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $239.88 / $3,981.07
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $223.87 / $295.12
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $239.88 / $1,737.80
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $169.82 / $457.09
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $234.42
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $891.25 / $2,344.23
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $218.78 / $398.11
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $234.42 / $331.13
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$223.87 / $223.87 / $891.25
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $138.04 / $758.58
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $162.18 / $173.78
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $371.54 / $446.68
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,659.59 / $3,311.31
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $134.90 / $354.81