go back

Arkansas rates for HCPCS 15101

Split-thickness autograft, trunk, arms, legs; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$132.38 / $1,181.00 / $3,109.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,414.94 / $2,414.94 / $2,414.94
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$130.00 / $337.00 / $858.00