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Hawaii rates for HCPCS 15771

Grafting of autologous fat harvested by liposuction technique to trunk, breasts, scalp, arms, and/or legs; 50 cc or less injectate

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,924.00 / $2,747.00 / $5,484.00
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$576.35 / $733.53 / $886.51
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,155.00 / $2,155.00 / $2,155.00