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Montana rates for HCPCS 15110

Epidermal autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children

Facilitymedian $1,380 · 10th–90th $1,175–$1,6600%20%10th90th$1,380$1.0K$2.0K$5.0K$10.0K$20.0K$50.0K$100.0K

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
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46,773.51 / $75,857.76 / $95,499.26
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,122.02 / $1,122.02
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,380.38 / $1,548.82
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $870.96 / $1,659.59
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,148.15 / $1,148.15