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Missouri 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
$154.88 / $2,570.40 / $7,413.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $112.20 / $363.08
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$676.08 / $1,819.70 / $4,168.69
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.20 / $134.90 / $204.17
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $128.82 / $165.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.71 / $154.88 / $239.88
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$95.50 / $177.83 / $12,022.64
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.15 / $165.96 / $1,000.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$338.84 / $707.95 / $1,412.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.50 / $125.89 / $218.78