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Wisconsin 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 $1,514 · 10th–90th $204–$5,8880%10%10th90th$1,514Professionalmedian $407 · 10th–90th $204–$7080%20%10th90th$407$2.0$10.0$50.0$200.0$1.0K$5.0K

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
$204.17 / $2,344.23 / $6,918.31
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $575.44 / $933.25
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $4,265.80 / $8,912.51
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $1,202.26 / $2,454.71
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $891.25 / $1,819.70
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $416.87 / $707.95
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $371.54 / $912.01
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $269.15 / $346.74
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,584.89 / $2,187.76