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Wyoming rates for HCPCS 15769

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$492.50 / $492.50 / $2,284.38
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$853.00 / $1,138.00 / $1,366.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$483.38 / $655.83 / $983.75
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,200.00 / $4,200.00 / $14,634.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$582.12 / $831.60 / $1,524.60