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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
$206.59 / $3,467.75 / $13,538.22
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$602.94 / $1,150.29 / $1,973.56
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$155.26 / $237.58 / $355.09
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$225.00 / $1,221.00 / $3,585.00