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Tennessee 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
$138.97 / $1,285.44 / $6,681.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$108.00 / $143.00 / $623.00
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $724.47 / $724.47
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$294.00 / $808.00 / $2,577.00