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New Mexico 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
$584.80 / $5,000.27 / $7,838.38
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,513.39 / $8,428.67 / $14,120.27
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$431.04 / $431.04 / $518.63
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,085.00 / $3,085.00 / $4,616.00