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Indiana 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
$190.55 / $3,801.89 / $5,623.41
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$162.18 / $2,187.76 / $3,388.44
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$141.25 / $141.25 / $147.91
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$933.25 / $2,290.87 / $7,413.10