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Missouri 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
$520.25 / $3,288.26 / $7,365.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,088.00 / $4,247.00 / $9,663.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$372.79 / $707.00 / $3,700.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,708.00 / $3,502.00 / $6,854.00