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Arizona rates for HCPCS 15777

Implantation of biologic implant (eg, acellular dermal matrix) for soft tissue reinforcement (ie, breast, trunk) (List separately in addition to code for primary procedure)

Facilitymedian $1,445 · 10th–90th $316–$5,6230%5%10th90th$1,445$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
$446.68 / $1,513.56 / $5,623.41
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$234.42 / $1,348.96 / $2,238.72
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $2,691.53 / $5,011.87
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $316.23 / $2,041.74
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $1,122.02 / $2,137.96