go back

Wyoming 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
$745.97 / $745.97 / $813.68
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,288.00 / $1,718.00 / $1,876.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$721.40 / $922.75 / $1,278.83
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,200.00 / $4,200.00 / $14,634.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$779.24 / $1,383.61 / $2,302.30