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New Hampshire 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)

Facilitymedian $1,820 · 10th–90th $589–$9,7720%10%20%10th90th$1,820Professionalmedian $186 · 10th–90th $135–$4070%10%10th90th$186$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $1,819.70 / $9,772.37
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $147.91 / $363.08
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $213.80 / $302.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $218.78 / $389.05
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,413.10 / $7,413.10 / $7,413.10
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $281.84 / $446.68
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,413.10 / $7,413.10 / $7,413.10
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $245.47 / $512.86