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Kansas 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
$870.96 / $4,786.30 / $11,220.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$275.42 / $478.63 / $851.14
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,778.28 / $1,862.09 / $1,949.84
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $707.95 / $707.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$630.96 / $630.96 / $630.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.78 / $616.60 / $977.24
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.95 / $1,778.28 / $6,309.57
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.63 / $602.56 / $3,548.13
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,862.09 / $2,884.03 / $6,309.57
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.78 / $575.44 / $758.58