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Missouri 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
$221.36 / $2,507.00 / $7,365.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,088.00 / $4,247.00 / $9,663.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$105.39 / $195.88 / $757.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$247.00 / $718.00 / $1,667.00