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South Dakota 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 $562 · 10th–90th $138–$4,8980%20%10th90th$562Professionalmedian $309 · 10th–90th $214–$3800%10%20%10th90th$309$200.0$500.0$1.0K$2.0K$5.0K

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
$138.04 / $562.34 / $5,370.32
Avera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $165.96 / $288.40
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $269.15 / $1,047.13
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $323.59 / $416.87
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $288.40 / $380.19
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $812.83