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Washington 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

Facilitymedian $1,585 · 10th–90th $741–$14,4540%5%10%10th90th$1,585$100.0$500.0$2.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $4,073.80 / $16,982.44
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,244.36 / $9,549.93 / $19,498.45
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,754.23 / $2,754.23 / $4,677.35
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $1,202.26 / $4,570.88
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $1,202.26 / $1,202.26
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$794.33 / $794.33 / $851.14
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,918.31 / $10,000.00 / $19,498.45
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,235.94 / $11,481.54 / $20,417.38