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California rates for HCPCS 57109

Vaginectomy, partial removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy) with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,597.00 / $5,717.00 / $17,054.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,421.18 / $1,597.00 / $8,930.48
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,145.00 / $9,241.00 / $18,708.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,937.17 / $2,539.01 / $4,881.66
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.00 / $100.00 / $11,012.46
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,157.80 / $1,776.49 / $4,379.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,596.84 / $2,149.52 / $5,821.39
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,250.54 / $1,946.83 / $2,336.19
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,745.60 / $2,238.85 / $3,966.27
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $12,855.68 / $16,241.92
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12,514.24 / $12,860.16 / $14,662.88
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,597.00 / $2,130.41 / $2,974.70
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,596.84 / $2,222.96 / $4,804.24
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,541.21 / $5,541.21 / $5,541.21
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,250.54 / $1,767.54 / $2,160.32
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,800.00 / $7,454.00 / $16,148.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,332.18 / $1,889.25 / $5,685.54