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Georgia 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
$190.55 / $5,370.32 / $7,413.10
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$870.96 / $1,905.46 / $2,818.38
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.82 / $229.09 / $309.03
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$354.81 / $1,513.56 / $2,511.89