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Washington rates for HCPCS 57180

Introduction of any hemostatic agent or pack for spontaneous or traumatic nonobstetrical vaginal hemorrhage (separate procedure)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.86 / $170.81 / $362.52
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.14 / $399.91 / $1,474.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.59 / $328.78 / $605.73
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$143.02 / $237.60 / $378.75
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.58 / $277.12 / $476.75
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$210.34 / $316.66 / $503.43
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$197.09 / $291.86 / $463.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$198.54 / $395.47 / $573.79