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Idaho 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
$1,412.54 / $4,466.84 / $5,495.41
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$302.00 / $537.03 / $794.33
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$125.89 / $186.21 / $257.04
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,819.70 / $8,317.64 / $9,332.54