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Indiana 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
$501.55 / $3,353.10 / $10,817.26
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,614.00 / $7,572.00 / $18,942.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$474.16 / $604.32 / $750.21
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,623.15 / $2,623.15 / $2,623.15
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,932.00 / $8,025.00 / $11,038.00