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Texas 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
$732.00 / $2,236.00 / $7,513.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,521.50 / $1,731.01 / $2,471.27
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,272.77 / $3,971.98 / $7,369.40
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,591.33 / $2,021.99 / $2,846.28
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,586.96 / $1,586.96 / $1,586.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,734.46 / $2,300.07 / $3,480.46
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $55.00 / $15,801.68
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12,514.24 / $12,860.16 / $14,662.88
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,633.50 / $2,112.63 / $3,908.01
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,199.23 / $2,588.33 / $3,045.10
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,125.80 / $2,125.80 / $2,125.80
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,633.50 / $2,119.39 / $4,000.18
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,734.46 / $2,378.94 / $3,618.32
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,154.00 / $3,314.00 / $7,600.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,382.55 / $1,914.14 / $2,990.71
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,443.83 / $1,647.51 / $2,277.80