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Washington 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 $1,585 · 10th–90th $912–$10,7150%10%10th90th$1,585Professionalmedian $912 · 10th–90th $513–$1,8200%5%10%10th90th$912$50.0$200.0$1.0K$5.0K$20.0K

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
$1,122.02 / $1,862.09 / $17,782.79
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $741.31 / $1,659.59
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,548.13 / $4,897.79 / $10,000.00
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $1,148.15 / $1,862.09
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$562.34 / $912.01 / $2,344.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $1,122.02 / $2,041.74
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $1,318.26 / $2,691.53
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $1,318.26 / $1,905.46
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $269.15
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$851.14 / $1,380.38 / $1,445.44
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$977.24 / $977.24 / $1,000.00
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $1,148.15 / $1,819.70
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,388.44 / $5,011.87 / $10,000.00
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $1,148.15 / $1,698.24
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,905.46 / $6,456.54 / $11,748.98
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $912.01 / $1,778.28
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $891.25 / $1,174.90