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Iowa rates for HCPCS 15769

Grafting of autologous soft tissue, other, harvested by direct excision (eg, fat, dermis, fascia)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$407.38 / $4,786.30 / $7,079.46
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$346.74 / $537.03 / $1,202.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,096.48 / $1,148.15 / $1,380.38
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.58 / $676.08 / $2,884.03
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$588.84 / $3,715.35 / $9,772.37
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $812.83 / $1,479.11
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $1,174.90 / $1,819.70
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,786.30 / $7,762.47 / $10,715.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $724.44 / $1,348.96
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $870.96 / $1,023.29