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Illinois rates for HCPCS 57295

Revj/Rmvl Prosthetic Vaginal Graft Vaginal App

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$659.17 / $1,848.00 / $5,994.30
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,035.98 / $5,700.78 / $11,632.52
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$875.00 / $875.00 / $908.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$535.98 / $852.69 / $1,935.42
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$930.00 / $3,951.00 / $6,625.00