| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $0.85 | $2,089.30 | $5,495.41 | |
Martin's Point
| Facility | $0.85 | $1,819.70 | $5,495.41 |
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 | $0.85 | $2,089.30 | $5,495.41 | |
Martin's Point
| Facility | $0.85 | $1,819.70 | $5,495.41 |