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Michigan 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
$170.23 / $2,056.00 / $4,933.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$800.13 / $1,088.01 / $2,555.04
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$183.45 / $2,056.00 / $4,933.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$464.00 / $1,247.00 / $1,844.00