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Arkansas rates for HCPCS 15111

Epidermal 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
$125.05 / $803.00 / $2,812.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$447.90 / $447.90 / $447.90
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$130.00 / $337.00 / $768.00