go back

Florida 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
$682.63 / $4,109.00 / $10,632.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$593.96 / $750.64 / $1,151.64
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$432.00 / $977.92 / $1,164.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$605.35 / $839.29 / $1,334.04
Florida Blue
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,144.00 / $5,731.00 / $11,037.00
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$455.15 / $666.31 / $1,021.46
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.98 / $639.49 / $1,024.66
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,014.00 / $3,611.00 / $8,105.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$627.53 / $803.17 / $1,397.19
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$553.54 / $667.93 / $667.93