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Minnesota 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
$478.63 / $575.44 / $5,248.07
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,187.76 / $3,630.78 / $8,317.64
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,548.82 / $2,187.76 / $5,248.07
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,698.24 / $2,089.30 / $4,073.80
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.44 / $1,023.29 / $5,495.41
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,584.89 / $4,265.80 / $6,760.83