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Michigan 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 $1,950 · 10th–90th $263–$6,4570%10%20%10th90th$1,950$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
$263.03 / $2,041.74 / $4,897.79
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$977.24 / $1,659.59 / $10,232.93
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $645.65 / $645.65
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $281.84 / $281.84
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $1,949.84 / $5,011.87
Health Alliance Plan
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$977.24 / $5,370.32 / $10,232.93
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$467.74 / $1,258.93 / $2,454.71