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Virginia 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 $955 · 10th–90th $182–$7,0790%5%10th90th$955Professionalmedian $240 · 10th–90th $120–$4170%10%20%10th90th$240$100.0$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $1,548.82 / $7,079.46
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $239.88 / $295.12
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $416.87 / $416.87
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $204.17 / $323.59
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $194.98 / $1,659.59
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $1,047.13 / $2,344.23