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Maryland 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
$0.99 / $239.58 / $4,845.92
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$201.49 / $267.98 / $440.18