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Arizona rates for HCPCS 15152

Tissue cultured skin autograft, trunk, arms, legs; 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
Facility
Modifier
Low / Median / High Price
$1,445.44 / $3,090.30 / $6,309.57
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$275.42 / $891.25 / $1,348.96
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$131.83 / $173.78 / $1,905.46
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$691.83 / $1,230.27 / $2,187.76