go back

New Hampshire rates for HCPCS 15769

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

Facilitymedian $3,890 · 10th–90th $2,399–$14,7910%10%20%10th90th$3,890Professionalmedian $575 · 10th–90th $427–$1,2020%10%10th90th$575$100.0$200.0$500.0$1.0K$2.0K$5.0K$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
$2,398.83 / $3,388.44 / $14,791.08
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $467.74 / $912.01
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,467.37 / $4,677.35 / $6,309.57
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $851.14 / $1,230.27
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,495.41 / $5,495.41 / $5,495.41
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $645.65 / $1,174.90
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10,000.00 / $10,000.00 / $10,000.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $870.96 / $1,412.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10,000.00 / $10,000.00 / $10,000.00
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $776.25 / $1,862.09