go back

Kentucky 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
$593.91 / $1,031.58 / $5,320.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.41 / $746.60 / $1,063.47
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,359.00 / $2,292.00 / $4,229.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$499.93 / $645.09 / $943.21
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$669.77 / $815.55 / $952.13
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$641.87 / $925.86 / $1,567.46
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$550.33 / $1,208.22 / $1,587.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$651.94 / $847.30 / $1,505.09
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $1,018.85
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$590.00 / $1,450.00 / $4,039.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$717.18 / $896.47 / $1,398.49