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California rates for HCPCS 57295

Revision (including removal) of prosthetic vaginal graft; vaginal approach

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,387.00 / $6,695.00 / $17,701.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,456.00 / $6,986.00 / $13,707.00
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.00 / $100.00 / $5,509.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,115.08 / $2,499.65 / $5,888.95
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$390.16 / $573.07 / $773.64
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$507.42 / $658.20 / $1,158.43
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $1,857.96 / $9,496.40
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$507.42 / $638.14 / $918.48
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,610.00 / $7,384.00 / $16,148.00