| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $138.88 | $180.40 | $8,500.00 | |
Medica
| Facility | $138.88 | $236.11 | $612.50 |
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 | $138.88 | $180.40 | $8,500.00 | |
Medica
| Facility | $138.88 | $236.11 | $612.50 |