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Oklahoma 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
$501.19 / $2,398.83 / $6,606.93
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$134.90 / $199.53 / $1,862.09
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.04 / $707.95 / $1,659.59