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Arizona rates for HCPCS 15774

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
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,170.00 / $2,753.00 / $5,506.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$294.10 / $1,107.20 / $1,810.96
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$136.81 / $196.82 / $1,234.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$683.00 / $1,423.00 / $2,114.00