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Idaho 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
$1,407.00 / $4,500.00 / $7,045.00
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$167.58 / $225.09 / $321.52
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,800.00 / $8,244.00 / $9,193.00