go back

California 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 $4,786 · 10th–90th $1,349–$13,4900%10%10th90th$4,786Professionalmedian $209 · 10th–90th $100–$3890%5%10%10th90th$209$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
$1,778.28 / $7,079.46 / $18,197.01
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,570.40 / $4,466.84 / $12,882.50
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $5,248.07 / $10,471.29
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $123.03 / $295.12
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $213.80 / $389.05
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,951.21 / $45,708.82 / $45,708.82
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $173.78 / $309.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $1,584.89 / $6,760.83