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Iowa 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 $3,467 · 10th–90th $166–$6,4570%5%10th90th$3,467Professionalmedian $275 · 10th–90th $115–$6460%10%10th90th$275$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
$162.18 / $3,801.89 / $6,760.83
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $223.87 / $645.65
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $309.03 / $1,778.28
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $295.12 / $501.19
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,621.81 / $2,951.21