go back

Nebraska rates for HCPCS 15110

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,653.00 / $5,463.36 / $13,841.56
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,335.87 / $4,387.57 / $8,486.99
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$661.54 / $1,444.95 / $3,331.88
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,460.00 / $1,743.97 / $2,242.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,044.00 / $3,726.00 / $7,934.00