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South Carolina 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
$204.17 / $7,762.47 / $13,489.63
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$602.56 / $1,096.48 / $1,949.84
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$144.54 / $208.93 / $354.81
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$380.19 / $1,202.26 / $3,548.13