go back

Kentucky 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
$130.72 / $282.93 / $4,227.55
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,584.00 / $10,099.00 / $11,253.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$151.04 / $193.61 / $226.56
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$252.65 / $252.65 / $252.65
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.00 / $597.00 / $3,176.00