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Missouri 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
$177.23 / $851.00 / $6,576.52
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,088.00 / $4,247.00 / $9,663.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$108.37 / $202.12 / $757.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$245.00 / $760.00 / $1,300.00