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Louisiana 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
$587.28 / $2,397.00 / $6,029.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,663.56 / $6,828.12 / $13,858.17
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,494.85 / $3,494.85 / $3,494.85
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$882.00 / $3,238.00 / $8,257.00