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Minnesota 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
$457.09 / $3,801.89 / $6,760.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.19 / $489.78 / $1,995.26
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,187.76 / $7,079.46 / $16,595.87
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$741.31 / $1,047.13 / $1,737.80
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,230.27 / $1,737.80 / $4,168.69
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.76 / $1,445.44 / $2,238.72
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,348.96 / $1,659.59 / $3,235.94
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $1,174.90 / $1,905.46
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$501.19 / $851.14 / $9,332.54
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.81 / $851.14 / $1,949.84
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,584.89 / $6,760.83 / $10,715.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $870.96 / $1,737.80