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Michigan 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 $2,884 · 10th–90th $832–$4,8980%20%10th90th$2,884Professionalmedian $692 · 10th–90th $501–$1,0960%10%10th90th$692$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$831.76 / $2,884.03 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $660.69 / $1,122.02
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $154.88 / $154.88
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $912.01 / $912.01
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $676.08 / $2,818.38
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$741.31 / $2,884.03 / $4,897.79
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $831.76 / $1,380.38
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $630.96 / $1,000.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,621.81 / $3,981.07 / $7,244.36
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $724.44 / $977.24