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Arizona 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)

Facilitymedian $3,236 · 10th–90th $309–$7,4130%5%10%10th90th$3,236$100.0$500.0$2.0K$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
$2,041.74 / $4,168.69 / $7,762.47
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$275.42 / $1,258.93 / $2,238.72
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$104.71 / $190.55 / $1,905.46
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $1,122.02 / $2,187.76