go back

Hawaii 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
$988.00 / $2,898.00 / $3,444.00
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$159.44 / $214.24 / $272.66
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,078.00 / $1,078.00 / $1,078.00