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Oklahoma 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
$1,000.00 / $3,779.00 / $12,600.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,374.38 / $8,476.95 / $13,489.91
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$112.14 / $196.40 / $1,582.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $610.00 / $1,883.00