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North Dakota 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
$144.54 / $162.18 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.82 / $162.18 / $234.42
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$309.03 / $354.81 / $416.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.47 / $354.81 / $501.19
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$162.18 / $213.80 / $478.63
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.97 / $316.23 / $1,513.56
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,677.35 / $5,128.61 / $5,128.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.78 / $275.42 / $380.19