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Maryland 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
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$196.70 / $261.61 / $428.13