go back

Wisconsin rates for HCPCS 15771

Grafting Of Autologous Fat By Lipo 50 Cc Or Less

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$507.44 / $2,455.48 / $8,243.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,060.00 / $7,344.00 / $10,517.23
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,605.80 / $1,876.50 / $3,026.73
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$421.48 / $614.11 / $1,038.02
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$507.44 / $1,247.58 / $11,598.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$421.48 / $614.11 / $1,038.02
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$797.28 / $1,463.22 / $2,115.71
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,401.16 / $2,401.16 / $2,401.16
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,073.00 / $9,837.00 / $12,062.00