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Pennsylvania 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)

Facilitymedian $2,692 · 10th–90th $589–$8,3180%5%10th90th$2,692$100.0$500.0$2.0K$10.0K$50.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $2,691.53 / $8,317.64
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,344.23 / $2,570.40 / $57,543.99
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$537.03 / $1,905.46 / $6,606.93
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $112.20 / $263.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $630.96 / $4,466.84