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New Mexico 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
$846.94 / $5,000.27 / $7,838.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$646.99 / $846.94 / $3,485.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,419.71 / $8,378.81 / $13,001.91
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$475.33 / $861.37 / $1,281.68
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$711.90 / $1,054.29 / $1,397.44
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $741.06 / $1,327.13
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$665.15 / $972.88 / $1,304.95
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$733.16 / $1,167.93 / $1,587.85
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$559.00 / $3,610.50 / $8,000.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$956.90 / $1,341.37 / $2,036.61