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Illinois rates for HCPCS 15773

Grafting Of Autologous Fat By Lipo 25 Cc Or Less

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$557.24 / $1,842.00 / $5,665.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,192.85 / $4,301.58 / $10,006.78
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$875.00 / $875.00 / $908.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$603.89 / $928.40 / $3,038.15
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$749.00 / $2,588.00 / $5,026.00