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New Mexico 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
$639.00 / $1,794.50 / $7,838.38
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,446.13 / $15,464.34 / $25,906.89
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$426.69 / $426.69 / $514.29
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,602.00 / $9,127.00 / $10,150.00