go back

Washington rates for HCPCS 57120

Colpocleisis (Le Fort type)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$983.66 / $5,132.00 / $20,680.40
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$717.55 / $13,249.10 / $26,963.11
Asuris Northwest Health
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$719.36 / $1,196.53 / $1,196.53
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,164.22 / $3,164.22 / $5,271.55
Kaiser Permanente
Facility/Professional
Facility
Modifier
Low / Median / High Price
$651.88 / $1,143.11 / $8,968.34
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$713.93 / $985.79 / $1,075.34
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$717.55 / $733.49 / $1,964.09
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,140.29 / $14,087.45 / $26,963.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,155.00 / $3,297.00 / $12,835.00