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New York 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
$596.57 / $4,640.82 / $13,938.36
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,100.00 / $7,264.00 / $12,274.00
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$669.99 / $1,254.00 / $8,917.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$866.73 / $866.73 / $13,296.25
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$250.00 / $494.00 / $1,361.86
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,118.25 / $2,644.48 / $10,815.91
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$597.00 / $866.73 / $23,610.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,264.00 / $5,735.00 / $12,177.00
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$549.61 / $549.61 / $629.98