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Arkansas rates for HCPCS 15131

Dermal 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)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$108.96 / $803.00 / $2,812.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.69 / $100.61 / $134.10
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$88.18 / $116.70 / $129.66
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,620.03 / $1,620.03 / $1,620.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.98 / $109.74 / $153.09
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$130.00 / $345.00 / $768.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.70 / $104.57 / $182.19