go back

Rhode Island 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
$471.06 / $2,778.87 / $3,955.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$482.02 / $621.21 / $751.57
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$648.48 / $831.02 / $1,164.63
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.41 / $908.24 / $1,649.04
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,838.00 / $5,111.00 / $9,622.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.26 / $895.19 / $1,505.98