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Texas 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)

Facilitymedian $2,570 · 10th–90th $724–$6,9180%5%10th90th$2,570Professionalmedian $813 · 10th–90th $603–$1,5140%10%10th90th$813$50.0$200.0$1.0K$5.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $2,818.38 / $7,079.46
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $812.83 / $1,513.56
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $616.60 / $851.14
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,584.89 / $2,691.53 / $5,495.41
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $707.95 / $1,122.02
Baylor Scott & White
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$691.83 / $1,819.70 / $3,715.35
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $1,995.26 / $1,995.26
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $954.99 / $1,445.44
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,309.57 / $28,840.32 / $28,840.32
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6,165.95 / $7,413.10 / $7,413.10
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $1,000.00 / $4,073.80
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $1,071.52 / $1,778.28
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $602.56
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $891.25 / $1,318.26
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $977.24 / $1,513.56
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$776.25 / $2,041.74 / $4,073.80
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $812.83 / $1,174.90
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $891.25 / $954.99