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Illinois 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
$172.99 / $1,225.00 / $5,091.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$552.62 / $1,182.08 / $2,367.11
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$875.00 / $875.00 / $908.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.75 / $185.97 / $478.94
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$165.00 / $963.00 / $3,686.00