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Alaska rates for HCPCS 15157

Tissue cultured skin autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$489.78 / $5,888.44 / $14,125.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.82 / $218.78 / $794.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562.34 / $562.34 / $602.56
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.04 / $181.97 / $1,148.15
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.54 / $467.74 / $602.56
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.19 / $660.69 / $776.25
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.04 / $218.78 / $1,148.15
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $257.04 / $562.34
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.47 / $446.68 / $676.08