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Missouri rates for HCPCS 15769

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

Facilitymedian $4,074 · 10th–90th $977–$9,5500%5%10%10th90th$4,074Professionalmedian $490 · 10th–90th $316–$1,2020%10%10th90th$490$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
$616.60 / $4,073.80 / $11,220.18
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $489.78 / $1,412.54
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,238.72 / $4,570.88 / $8,912.51
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $512.86 / $831.76
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $478.63 / $616.60
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $616.60 / $1,000.00
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $912.01 / $7,079.46
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $602.56 / $3,548.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137.96 / $3,019.95 / $5,128.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $524.81 / $851.14