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Wisconsin 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 $4,266 · 10th–90th $1,778–$7,0790%10%20%10th90th$4,266Professionalmedian $1,445 · 10th–90th $724–$2,1380%10%20%10th90th$1,445$1.0$5.0$20.0$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
$416.87 / $1,230.27 / $6,165.95
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,630.27 / $4,570.88 / $7,079.46
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,584.89 / $1,819.70 / $2,951.21
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $4,265.80 / $8,912.51
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $3,235.94 / $6,165.95
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$691.83 / $3,890.45 / $4,365.16
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $1,445.44 / $2,137.96
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,801.89 / $3,801.89 / $5,623.41
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $912.01 / $1,096.48
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,884.03 / $3,548.13 / $6,918.31