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North Carolina 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 $282 · 10th–90th $120–$5,6230%5%10%10th90th$282Professionalmedian $240 · 10th–90th $240–$3390%20%40%90th$240$100.0$500.0$2.0K$10.0K$50.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $363.08 / $6,918.31
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $239.88 / $338.84
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $177.83 / $295.12
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $831.76 / $1,995.26
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,951.21 / $2,951.21 / $45,708.82