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Kansas 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
$224.63 / $4,376.00 / $12,154.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$505.00 / $505.00 / $505.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$110.75 / $220.08 / $2,819.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$191.00 / $550.00 / $1,769.00