go back

Oklahoma rates for HCPCS 15769

Grafting Of Autologous Soft Tiss By Direct Exc

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,300.00 / $4,112.00 / $13,200.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.98 / $477.40 / $491.67
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,374.38 / $8,537.98 / $13,565.01
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.80 / $572.51 / $628.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$488.00 / $620.46 / $743.33
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$451.94 / $1,050.00 / $6,889.15
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$415.17 / $516.91 / $913.87
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,091.00 / $4,054.00 / $7,077.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$400.16 / $500.20 / $725.56