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Idaho 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 $5,495 · 10th–90th $389–$33,8840%5%10%10th90th$5,495$200.0$1.0K$5.0K$20.0K

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
$1,412.54 / $8,128.31 / $33,884.42
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$3,467.37 / $5,370.32 / $5,370.32
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$794.33 / $1,995.26 / $6,760.83
BCBS
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$1,202.26 / $2,884.03 / $10,232.93
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $338.84 / $15,135.61
Moda Health
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$3,467.37 / $5,370.32 / $5,370.32
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,819.70 / $8,317.64 / $9,332.54