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Ohio 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

Facilitymedian $2,951 · 10th–90th $631–$10,2330%5%10th90th$2,951$100.0$500.0$2.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$562.34 / $3,019.95 / $10,715.19
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,000.00 / $2,884.03 / $7,943.28
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $501.19 / $575.44
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$416.87 / $758.58 / $21,379.62
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$21,379.62 / $21,379.62 / $21,379.62
SummaCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $1,258.93
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,548.82 / $2,570.40 / $5,754.40