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Virginia 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 $1,622 · 10th–90th $251–$9,3330%5%10th90th$1,622Professionalmedian $263 · 10th–90th $200–$3090%20%10th90th$263$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $2,630.27 / $9,332.54
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$467.74 / $1,380.38 / $9,772.37
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $363.08
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $263.03 / $309.03
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $245.47 / $389.05
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $288.40 / $4,073.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $1,047.13 / $2,344.23