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Texas 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 $1,905 · 10th–90th $275–$7,5860%5%10th90th$1,905$2.0$10.0$50.0$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
$457.09 / $2,187.76 / $7,585.78
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$223.87 / $1,148.15 / $9,120.11
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,096.48 / $2,041.74 / $6,309.57
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $177.83 / $223.87
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $56.23 / $1,318.26
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $645.65 / $5,248.07
Moda Health
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$562.34 / $1,548.82 / $9,120.11
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $223.87 / $309.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $954.99 / $2,398.83