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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)

Facilitymedian $263 · 10th–90th $1–$5,7540%10%10th90th$263Professionalmedian $251 · 10th–90th $186–$3550%20%10th90th$251$1.0$5.0$20.0$100.0$500.0$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.98 / $1,905.46 / $5,754.40
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $251.19 / $354.81
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $128.82 / $128.82