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Wisconsin 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)

Facilitymedian $1,096 · 10th–90th $126–$3,5480%10%10th90th$1,096Professionalmedian $355 · 10th–90th $219–$5130%10%10th90th$355$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $288.40 / $1,905.46
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,584.89 / $6,165.95
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $426.58 / $691.83
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $380.19 / $3,981.07
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $380.19 / $1,737.80
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $891.25 / $2,344.23
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $354.81 / $512.86
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $354.81 / $891.25
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $269.15
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,659.59 / $3,311.31