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Washington 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 $1,514 · 10th–90th $759–$13,8040%10%10th90th$1,514$500.0$1.0K$2.0K$5.0K$10.0K$20.0K

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
$954.99 / $5,128.61 / $18,620.87
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,981.07 / $4,897.79 / $10,000.00
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,380.38 / $1,380.38 / $2,344.23
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $1,202.26 / $2,691.53
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $1,174.90 / $1,174.90
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $812.83
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,715.35 / $5,011.87 / $10,000.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,698.24 / $6,606.93 / $11,748.98