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Nebraska 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
$543.78 / $4,241.22 / $13,841.56
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,335.87 / $4,520.96 / $8,486.99
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$165.65 / $235.06 / $655.48
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$306.81 / $396.00 / $517.78
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,056.00 / $1,527.00 / $4,317.00