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Iowa 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
$2,218.00 / $3,576.15 / $7,119.04
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$184.25 / $261.95 / $1,012.62
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$216.78 / $346.73 / $1,607.00
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$298.01 / $396.00 / $517.78
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,151.00 / $1,640.00 / $3,560.25