go back

North Dakota 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
$480.63 / $2,500.00 / $3,080.15
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$480.63 / $713.94 / $1,441.89