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Idaho rates for HCPCS 57295

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,897.00 / $4,500.00 / $7,761.00
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$581.35 / $876.08 / $1,121.38
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,781.66 / $7,272.33 / $9,472.49
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,550.00 / $12,152.00 / $12,233.00