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Pennsylvania rates for HCPCS 15769

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

Facilitymedian $5,370 · 10th–90th $813–$8,5110%10%10th90th$5,370Professionalmedian $479 · 10th–90th $245–$1,1480%20%40%10th90th$479$1.0$10.0$100.0$1.0K$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
$812.83 / $5,370.32 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $457.09 / $1,258.93
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,549.93 / $10,000.00 / $57,543.99
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $724.44 / $812.83
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $562.34 / $933.25
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $707.95 / $794.33
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $575.44 / $758.58
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.50 / $416.87 / $20,417.38
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $3,801.89 / $8,511.38
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $489.78 / $1,148.15
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $549.54 / $549.54
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$467.74 / $478.63 / $537.03
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $467.74 / $501.19
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,187.76 / $4,897.79 / $11,481.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $537.03 / $954.99