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Illinois 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
$281.84 / $1,862.09 / $5,623.41
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$602.56 / $1,621.81 / $3,090.30
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.88 / $251.19 / $891.25
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$151.36 / $851.14 / $2,630.27