go back

Virginia 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 $1,230 · 10th–90th $123–$7,9430%5%10th90th$1,230Professionalmedian $240 · 10th–90th $182–$3020%20%10th90th$240$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $4,073.80 / $8,317.64
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $239.88 / $288.40
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $302.00 / $338.84
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $177.83 / $295.12
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$104.71 / $151.36 / $4,073.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $1,047.13 / $2,344.23