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Hawaii 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
$988.00 / $2,898.00 / $3,444.00
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.41 / $209.20 / $266.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,078.00 / $1,078.00 / $1,078.00