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Arizona rates for HCPCS 15772

Grafting of autologous fat harvested by liposuction technique to trunk, breasts, scalp, arms, and/or legs; each additional 50 cc injectate, or part thereof (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$570.00 / $2,292.00 / $6,882.50
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$294.10 / $1,107.20 / $1,810.96
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$141.26 / $201.72 / $1,409.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$704.00 / $1,535.00 / $2,175.00