go back

South Dakota rates for HCPCS 15772

Grafting Of Autologous Fat By Lipo Ea Addl 50 Cc

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.59 / $183.38 / $183.38
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$173.60 / $249.43 / $821.00
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$318.51 / $414.13 / $584.01
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$193.50 / $289.16 / $375.85
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$821.00 / $821.00 / $821.00