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Vermont 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
Professional
Modifier
Low / Median / High Price
$728.88 / $863.81 / $1,884.36
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$764.12 / $1,075.89 / $2,491.56
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$915.47 / $1,253.26 / $2,491.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$915.47 / $1,220.63 / $3,548.46