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Montana 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)

Facilitymedian $200 · 10th–90th $170$2190%20%40%10th90th$200Professionalmedian $182 · 10th–90th $107$3980%10%10th90th$182$100.0$200.0$500.0

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
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $147.91 / $549.54
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $169.82 / $169.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $158.49 / $199.53
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $199.53 / $218.78
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $199.53 / $218.78
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$93.33 / $125.89 / $257.04
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $158.49 / $223.87
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $162.18 / $162.18
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $194.98 / $218.78