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Indiana 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 $4,571 · 10th–90th $234–$13,1830%5%10th90th$4,571$200.0$500.0$1.0K$2.0K$5.0K$10.0K$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
$234.42 / $4,897.79 / $13,182.57
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$1,778.28 / $1,949.84 / $5,370.32
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $245.47 / $478.63
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $245.47 / $275.42
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $281.84 / $436.52
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $2,290.87 / $7,413.10