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West Virginia 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
$548.71 / $5,389.26 / $7,302.82
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$540.53 / $600.13 / $653.85
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$866.73 / $866.73 / $866.73
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,015.82 / $8,093.51 / $14,204.23