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New York 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
$850.81 / $3,599.00 / $8,442.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$561.53 / $689.98 / $1,515.98
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,263.00 / $5,196.00 / $11,909.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$626.10 / $756.71 / $1,547.04
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,026.77 / $1,716.00 / $6,213.00
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,026.77 / $1,026.77 / $1,129.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,231.81 / $1,231.81 / $1,231.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$502.13 / $961.31 / $2,197.37
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$332.00 / $780.87 / $1,927.78
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$931.70 / $1,083.64 / $2,301.30
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$595.19 / $741.18 / $1,462.61
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$555.00 / $1,231.81 / $74,999.25
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$545.60 / $994.16 / $2,205.30
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,160.00 / $5,248.00 / $11,200.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$531.67 / $884.25 / $2,006.78
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$778.57 / $778.57 / $2,212.58
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$595.19 / $849.77 / $2,051.69