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Washington 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 $1,950 · 10th–90th $977–$11,2200%5%10%10th90th$1,950Professionalmedian $1,047 · 10th–90th $646–$2,1880%5%10%10th90th$1,047$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
$912.01 / $2,238.72 / $16,982.44
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $912.01 / $2,137.96
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,801.89 / $4,897.79 / $10,000.00
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $1,380.38 / $2,238.72
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$562.34 / $912.01 / $2,344.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $1,348.96 / $2,454.71
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,621.81 / $2,754.23
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,621.81 / $2,290.87
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $323.59
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $1,621.81 / $1,737.80
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,174.90 / $1,202.26
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $1,380.38 / $2,187.76
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,548.13 / $5,011.87 / $10,000.00
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $1,380.38 / $2,041.74
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,621.81 / $6,456.54 / $11,748.98
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,122.02 / $2,137.96
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $1,047.13 / $1,380.38