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Oklahoma 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
$838.00 / $3,165.00 / $8,400.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,868.30 / $6,114.08 / $9,735.10
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$503.98 / $668.84 / $4,012.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$498.00 / $1,928.00 / $3,790.62