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Michigan 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
$121.69 / $133.91 / $4,933.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$603.29 / $703.15 / $952.66
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$119.53 / $2,056.00 / $4,933.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$464.00 / $1,418.00 / $2,449.00