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Kansas 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
$959.99 / $3,569.00 / $10,439.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$613.46 / $860.21 / $1,169.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,461.10 / $3,241.55 / $3,933.39
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$787.59 / $926.58 / $1,101.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$442.00 / $442.00 / $442.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$723.15 / $1,049.51 / $1,450.28
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$693.21 / $1,010.00 / $3,918.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$887.31 / $1,020.40 / $6,396.72
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,031.00 / $1,450.00 / $3,405.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$864.35 / $941.29 / $1,366.20