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Oregon 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 $355 · 10th–90th $178–$7,9430%10%20%10th90th$355Professionalmedian $257 · 10th–90th $186–$4790%10%10th90th$257$100.0$200.0$500.0$1.0K$2.0K$5.0K$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
$223.87 / $457.09 / $13,182.57
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $245.47 / $478.63
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $257.04 / $457.09
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $354.81 / $371.54
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $223.87 / $426.58
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$389.05 / $4,073.80 / $6,165.95