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Oklahoma 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
$788.75 / $3,979.85 / $13,200.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,360.29 / $8,472.26 / $13,489.91
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$491.92 / $804.06 / $5,975.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,157.00 / $4,054.00 / $7,077.94