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Maine rates for HCPCS 15769

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

Facilitymedian $3,715 · 10th–90th $1,862–$7,5860%20%10th90th$3,715Professionalmedian $562 · 10th–90th $380–$1,0000%20%10th90th$562$1.0$5.0$20.0$100.0$500.0$2.0K$10.0K

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
$1,862.09 / $3,715.35 / $7,585.78
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $489.78 / $933.25
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $630.96 / $912.01
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $660.69 / $1,071.52
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $660.69 / $1,000.00
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $489.78 / $891.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $676.08 / $1,000.00