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Colorado 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
$766.00 / $3,593.25 / $8,734.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$633.74 / $785.28 / $1,248.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,434.00 / $5,126.00 / $9,729.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$836.91 / $1,094.07 / $1,694.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$779.56 / $974.79 / $1,316.00
Denver HMP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$746.80 / $965.96 / $1,270.50
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.99 / $1,121.78 / $1,707.93
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,577.00 / $4,182.00 / $7,179.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$896.47 / $1,142.65 / $1,807.76