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Virginia 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 $1,585 · 10th–90th $794–$7,2440%5%10th90th$1,585Professionalmedian $912 · 10th–90th $631–$1,6600%10%10th90th$912$500.0$1.0K$2.0K$5.0K$10.0K

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
$891.25 / $1,819.70 / $8,128.31
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $851.14 / $1,659.59
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,090.30 / $3,981.07 / $4,466.84
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $1,047.13 / $1,513.56
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $812.83 / $4,365.16
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,202.26 / $1,202.26
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $933.25 / $1,513.56
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $1,096.48 / $1,318.26
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,202.26 / $1,412.54
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $912.01 / $1,412.54
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,570.88 / $4,570.88 / $4,570.88
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $954.99 / $4,073.80
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $1,174.90 / $4,168.69
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,698.24 / $3,162.28 / $5,754.40
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $870.96 / $1,479.11