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Idaho 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
$888.72 / $4,500.00 / $6,607.20
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$605.27 / $783.58 / $1,038.08
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,793.45 / $8,854.77 / $10,870.07
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,360.00 / $16,762.00 / $17,870.00