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California 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 $4,365 · 10th–90th $912–$13,4900%10%10th90th$4,365Professionalmedian $240 · 10th–90th $174–$4680%20%10th90th$240$0.1$1.0$10.0$100.0$1.0K$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
$660.69 / $4,897.79 / $16,595.87
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$2,041.74 / $6,606.93 / $10,471.29
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,570.40 / $4,466.84 / $12,882.50
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $2,089.30 / $4,466.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $363.08
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $229.09 / $295.12
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $239.88 / $524.81
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $56.23 / $1,318.26
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $239.88 / $323.59
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $1,584.89 / $6,760.83