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Virginia 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
$195.16 / $2,045.99 / $8,294.00
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$148.91 / $219.40 / $265.91
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$153.21 / $207.25 / $311.68
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$148.38 / $195.64 / $819.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$296.00 / $1,045.00 / $2,364.00