go back

Mississippi 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
$615.00 / $1,140.00 / $2,010.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$599.67 / $863.81 / $1,603.35
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,065.94 / $1,065.94 / $1,065.94
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,335.00 / $1,335.00 / $1,335.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,014.96 / $1,014.96 / $4,002.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$614.01 / $1,016.12 / $1,426.32
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $32.34
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$624.00 / $1,530.00 / $3,672.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$762.00 / $932.01 / $1,816.76