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Arizona rates for HCPCS 15130

Dermal autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children

Facilitymedian $3,020 · 10th–90th $1,122–$6,7610%10%10th90th$3,020Professionalmedian $631 · 10th–90th $501–$1,5490%10%20%10th90th$631$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,737.80 / $3,715.35 / $6,760.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $616.60 / $1,621.81
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$549.54 / $2,454.71 / $4,570.88
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $588.84 / $2,398.83
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $660.69 / $1,202.26
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$562.34 / $758.58 / $3,801.89
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $741.31 / $5,370.32
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,737.80 / $2,884.03 / $5,370.32
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $630.96 / $954.99