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Arkansas rates for HCPCS 15100

Split-thickness autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children (except 15050)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$774.97 / $1,163.99 / $3,109.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$637.19 / $774.97 / $930.37
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,755.26 / $1,755.26 / $2,106.31
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$711.29 / $941.42 / $1,140.92
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,414.94 / $2,414.94 / $2,414.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$536.57 / $842.25 / $1,204.24
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$590.00 / $1,427.00 / $5,186.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$717.18 / $896.47 / $1,466.62