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New Mexico 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
$108.33 / $2,145.78 / $7,838.38
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.96 / $149.21 / $178.86
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$230.00 / $1,158.00 / $1,401.00