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Pennsylvania 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 $2,089 · 10th–90th $240–$8,3180%5%10th90th$2,089$100.0$500.0$2.0K$10.0K$50.0K

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
$239.88 / $2,041.74 / $8,317.64
AmeriHealth
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,548.13 / $4,570.88 / $12,302.69
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $1,995.26 / $2,951.21
Independence Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,511.89 / $3,630.78 / $11,748.98
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $1,513.56 / $6,165.95
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $144.54 / $186.21
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $630.96 / $4,466.84