go back

Wisconsin 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 $4,266 · 10th–90th $1,445$7,5860%10%10th90th$4,266Professionalmedian $1,072 · 10th–90th $617$2,6920%5%10th90th$1,072$50.0$200.0$1.0K$5.0K

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
$588.84 / $1,698.24 / $3,090.30
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $851.14 / $2,089.30
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,311.31 / $4,786.30 / $7,585.78
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $1,621.81 / $3,630.78
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,290.87 / $2,630.27 / $4,265.80
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $1,380.38 / $2,570.40
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$691.83 / $1,905.46 / $3,981.07
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,862.09 / $2,511.89
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $1,905.46 / $5,128.61
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $1,513.56 / $5,248.07
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $2,089.30
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,445.44 / $3,890.45 / $4,570.88
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $1,995.26 / $3,090.30
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,995.26 / $3,019.95
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,801.89 / $5,623.41 / $5,623.41
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $1,288.25 / $6,165.95
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,288.25 / $1,621.81
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $3,019.95 / $3,801.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,884.03 / $3,548.13 / $6,918.31
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $1,174.90 / $2,951.21