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California 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
$344.00 / $4,848.00 / $16,713.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,402.00 / $7,007.00 / $13,707.00
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$48.30 / $100.00 / $10,276.26
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$155.25 / $173.94 / $241.60
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$143.87 / $210.38 / $349.07
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $655.48 / $701.67
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$152.16 / $208.62 / $297.92
Sutter Health Plus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,836.00 / $2,836.00 / $2,836.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$559.00 / $1,533.00 / $7,317.00