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West Virginia 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
$478.63 / $562.34 / $1,584.89
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$524.81 / $524.81 / $645.65
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.67 / $851.14 / $851.14
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,230.27 / $1,230.27 / $5,754.40