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Maryland 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)

Facilitymedian $151 · 10th–90th $129$1510%50%10th$151Professionalmedian $91 · 10th–90th $72$1700%10%10th90th$91$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $91.20 / $169.82
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $97.72 / $112.20
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $100.00 / $173.78
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $120.23 / $218.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $151.36 / $151.36
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $100.00 / $177.83
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $109.65 / $165.96