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Utah 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 $3,388 · 10th–90th $2,239–$7,9430%20%10th90th$3,388Professionalmedian $245 · 10th–90th $178–$3630%10%20%10th90th$245$200.0$500.0$1.0K$2.0K$5.0K$10.0K

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
$2,238.72 / $3,388.44 / $7,943.28
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $245.47 / $354.81
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $4,466.84 / $5,128.61