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Nebraska 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 $6,457 · 10th–90th $224–$12,5890%10%10th90th$6,457Professionalmedian $347 · 10th–90th $240–$5250%20%10th90th$347$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
$407.38 / $7,244.36 / $13,489.63
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,311.31 / $4,365.16 / $8,511.38
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $263.03 / $1,230.27
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $346.74 / $524.81
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,548.82 / $4,466.84