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Washington, DC 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
$177.83 / $2,754.23 / $4,073.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.82 / $162.18 / $467.74
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.49 / $426.58 / $1,258.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.36 / $177.83 / $416.87
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.53 / $363.08 / $478.63
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$165.96 / $549.54 / $5,888.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.25 / $169.82 / $354.81