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North Dakota 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 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.11 / $457.09 / $645.65
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.14 / $1,023.29 / $1,230.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $977.24 / $1,479.11
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$478.63 / $588.84 / $812.83
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $831.76 / $3,548.13
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,819.70 / $2,041.74 / $2,041.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.63 / $776.25 / $1,202.26