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Washington 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 $437 · 10th–90th $229–$9,7720%5%10%10th90th$437$200.0$500.0$1.0K$2.0K$5.0K$10.0K$20.0K

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
$229.09 / $691.83 / $15,135.61
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $323.59 / $457.09
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $371.54 / $371.54
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $263.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $660.69 / $5,754.40