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South Carolina 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
$524.81 / $9,120.11 / $17,378.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.19 / $467.74 / $851.14
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.98 / $407.38 / $1,380.38
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$602.56 / $1,096.48 / $1,905.46
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$436.52 / $562.34 / $933.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,235.94 / $3,235.94 / $3,235.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $588.84 / $741.31
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$446.68 / $524.81 / $707.95
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $33.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,128.61 / $13,182.57 / $23,442.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.54 / $467.74 / $870.96