go back

Hawaii 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
$864.50 / $2,747.00 / $2,898.00
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$152.88 / $176.73 / $194.70
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,078.00 / $1,078.00 / $1,078.00