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New Jersey 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
$666.24 / $4,475.97 / $8,337.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$608.28 / $745.85 / $1,549.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$466.64 / $890.47 / $1,713.78
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$914.72 / $1,239.95 / $1,375.25
Horizon BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,588.91 / $4,075.77 / $7,893.03
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$673.46 / $981.24 / $1,409.99
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,705.00 / $5,523.00 / $9,152.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$503.82 / $848.84 / $1,689.20