go back

West Virginia 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
$163.52 / $175.05 / $1,400.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$155.38 / $163.52 / $177.39
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$167.02 / $200.42 / $218.36
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.10 / $194.10 / $194.10
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$279.39 / $279.39 / $279.39
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.91 / $212.16 / $468.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$149.88 / $219.52 / $325.74