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Arkansas rates for HCPCS 15773

Grafting of autologous fat harvested by liposuction technique to face, eyelids, mouth, neck, ears, orbits, genitalia, hands, and/or feet; 25 cc or less injectate

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$615.91 / $1,277.00 / $3,804.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,755.26 / $1,755.26 / $2,106.31
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$590.00 / $1,263.00 / $2,558.00