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Oklahoma 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 $1,514 · 10th–90th $309–$19,9530%5%10th90th$1,514$100.0$500.0$2.0K$10.0K$50.0K

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
$501.19 / $2,137.96 / $18,620.87
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$602.56 / $1,445.44 / $34,673.69
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $316.23 / $2,511.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $602.56 / $1,584.89