| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $530.34 | $6,541.00 | $13,413.92 | |
Moda Health
| Facility | $176.63 | $894.80 | $1,252.72 | |
Providence
| Facility | $176.63 | $894.80 | $1,252.72 |
Grafting of autologous fat harvested by liposuction technique to face, eyelids, mouth, neck, ears, orbits, genitalia, hands, and/or feet; each additional 25 cc injectate, or part thereof (List separately in addition to code for primary procedure)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $530.34 | $6,541.00 | $13,413.92 | |
Moda Health
| Facility | $176.63 | $894.80 | $1,252.72 | |
Providence
| Facility | $176.63 | $894.80 | $1,252.72 |