go back

Oklahoma 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
$625.00 / $2,876.00 / $7,500.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$135.04 / $166.46 / $180.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.93 / $204.49 / $258.56
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$155.00 / $224.72 / $1,676.40
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$159.21 / $196.68 / $1,516.65
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $610.00 / $1,883.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$149.85 / $185.24 / $271.49