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New Hampshire 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 $2,344 · 10th–90th $1,622–$9,7720%20%10th90th$2,344Professionalmedian $794 · 10th–90th $537–$1,7380%10%10th90th$794$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,949.84 / $2,398.83 / $9,772.37
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $616.60 / $1,445.44
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,513.56 / $1,737.80 / $3,890.45
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $912.01 / $1,348.96
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,819.70 / $1,819.70 / $1,819.70
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $933.25 / $1,778.28
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,549.93 / $9,549.93 / $9,549.93
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $1,148.15 / $2,041.74
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,549.93 / $9,549.93 / $9,549.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $1,023.29 / $2,238.72