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North Dakota 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
$67.08 / $133.68 / $2,000.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$133.68 / $199.08 / $401.04
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,978.00 / $1,978.00 / $1,978.00