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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
$691.83 / $4,897.79 / $13,182.57
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,073.80 / $7,762.47 / $13,803.84
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$676.08 / $1,258.93 / $8,912.51
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.67 / $870.96 / $50,118.72
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$295.12 / $562.34 / $1,258.93
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,737.80 / $2,290.87 / $10,715.19
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$588.84 / $50,118.72 / $75,857.76
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,398.83 / $5,248.07 / $12,302.69
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$302.00 / $537.03 / $588.84