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Vermont 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
Professional
Modifier
Low / Median / High Price
$661.19 / $714.75 / $1,932.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$766.28 / $999.18 / $1,801.66
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$780.29 / $1,043.29 / $1,801.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$848.69 / $984.21 / $3,289.62