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Maine rates for HCPCS 15156

Tissue cultured skin autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; additional 1 sq cm to 75 sq cm (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$118.94 / $126.08 / $126.08
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$146.91 / $190.12 / $284.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$122.12 / $225.83 / $318.61
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$185.49 / $227.67 / $333.12
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$118.94 / $118.94 / $126.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$155.55 / $219.91 / $308.39