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Pennsylvania 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 $2,692 · 10th–90th $589–$8,3180%5%10%10th90th$2,692Professionalmedian $87 · 10th–90th $78–$1660%20%40%10th90th$87$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
$724.44 / $2,691.53 / $8,317.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $87.10 / $158.49
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,801.89 / $4,466.84 / $57,543.99
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $147.91 / $181.97
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $104.71 / $173.78
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $162.18 / $177.83
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $123.03 / $173.78
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$537.03 / $1,905.46 / $6,606.93
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $85.11 / $165.96
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $177.83 / $354.81
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$27.54 / $91.20 / $102.33
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $91.20 / $102.33
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $630.96 / $4,466.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $102.33 / $186.21