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Wyoming 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
Professional
Modifier
Low / Median / High Price
$90.02 / $90.02 / $97.73
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$156.00 / $208.00 / $226.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.14 / $129.08 / $181.06
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$293.00 / $293.00 / $3,239.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.57 / $169.79 / $291.22