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Michigan 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
$587.30 / $1,370.00 / $4,933.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,826.88 / $2,484.16 / $5,833.73
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$601.47 / $1,370.00 / $4,933.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,527.00 / $4,857.00 / $6,327.00