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North Carolina rates for HCPCS 15155

Tissue cultured skin autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 25 sq cm or less

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$709.11 / $1,039.86 / $7,278.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$574.61 / $709.11 / $789.92
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$697.88 / $804.29 / $1,494.39
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$731.89 / $899.72 / $1,715.81
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$709.11 / $844.03 / $1,134.58
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$600.00 / $600.00 / $844.03
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,366.00 / $9,541.00 / $14,589.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$582.69 / $776.92 / $1,886.65
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,006.88 / $5,006.88 / $16,394.00
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,264.88 / $5,725.36 / $6,772.43