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Virginia 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 $1,175 · 10th–90th $107–$7,0790%5%10%10th90th$1,175Professionalmedian $141 · 10th–90th $107–$1780%20%10th90th$141$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $2,570.40 / $7,079.46
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $173.78 / $173.78
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $141.25 / $169.82
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $177.83 / $218.78
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$93.33 / $128.82 / $208.93
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $138.04 / $4,073.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $1,047.13 / $2,344.23