| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $67.08 | $133.68 | $2,000.00 | |
Medica
| Facility | $133.68 | $199.08 | $401.04 | |
United
| Facility | $1,978.00 | $1,978.00 | $1,978.00 |
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 | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $67.08 | $133.68 | $2,000.00 | |
Medica
| Facility | $133.68 | $199.08 | $401.04 | |
United
| Facility | $1,978.00 | $1,978.00 | $1,978.00 |