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Iowa 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
$419.57 / $2,234.00 / $6,066.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.08 / $268.33 / $1,043.71
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$223.29 / $358.79 / $1,607.00
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$306.62 / $410.74 / $532.52
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,204.00 / $1,607.00 / $2,126.00