| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $421.00 | $3,158.00 | $10,439.00 | |
Medica
| Facility | $55.00 | $183.05 | $1,087.00 | |
United
| Facility | $191.00 | $550.00 | $1,769.00 |
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 | $421.00 | $3,158.00 | $10,439.00 | |
Medica
| Facility | $55.00 | $183.05 | $1,087.00 | |
United
| Facility | $191.00 | $550.00 | $1,769.00 |