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Wisconsin 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)

Facilitymedian $832 · 10th–90th $155–$4,4670%10%10th90th$832Professionalmedian $389 · 10th–90th $195–$6920%10%20%10th90th$389$1.0$5.0$20.0$100.0$500.0$2.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $288.40 / $1,905.46
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $562.34 / $891.25
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $4,265.80 / $8,912.51
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $1,122.02 / $1,778.28
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $891.25 / $1,819.70
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $398.11 / $691.83
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $891.25
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $257.04 / $338.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,584.89 / $2,187.76