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Maryland 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
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,034.56 / $1,034.56 / $1,034.56
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$626.91 / $833.80 / $1,385.89