| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $265.73 | $4,500.00 | $53,931.39 | |
Moda Health
| Facility | $173.92 | $231.43 | $328.74 | |
United
| Facility | $1,800.00 | $8,244.00 | $9,193.00 |
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 | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $265.73 | $4,500.00 | $53,931.39 | |
Moda Health
| Facility | $173.92 | $231.43 | $328.74 | |
United
| Facility | $1,800.00 | $8,244.00 | $9,193.00 |