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Idaho rates for HCPCS 15151

Tissue cultured skin autograft, trunk, arms, legs; additional 1 sq cm to 75 sq cm (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,412.54 / $4,466.84 / $5,495.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $134.90 / $177.83
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$302.00 / $457.09 / $776.25
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.96 / $199.53 / $223.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.65 / $154.88 / $190.55
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.72 / $147.91 / $204.17
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.18 / $204.17 / $245.47
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $33.11
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.96 / $204.17 / $251.19
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.33 / $120.23 / $204.17
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,819.70 / $8,317.64 / $9,332.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.49 / $154.88 / $208.93