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West 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
$178.23 / $5,389.26 / $5,389.26
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$157.41 / $193.20 / $250.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$252.65 / $252.65 / $252.65
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,113.89 / $4,113.89 / $9,357.40