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New York 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
$169.30 / $2,626.00 / $7,307.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,100.00 / $7,264.00 / $12,274.00
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$188.90 / $188.90 / $8,917.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$244.66 / $244.66 / $14,648.00
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$87.66 / $179.70 / $378.81
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$244.66 / $244.66 / $74,999.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,283.00 / $2,597.00 / $4,583.00
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$151.91 / $151.91 / $179.18