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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
$625.00 / $2,876.00 / $7,500.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$134.77 / $197.15 / $1,676.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$139.00 / $634.00 / $1,883.00