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Indiana rates for HCPCS 57295

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$494.95 / $1,386.00 / $11,093.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,153.00 / $5,757.57 / $8,388.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$463.23 / $590.40 / $681.23
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,243.79 / $2,243.79 / $2,243.79
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,364.00 / $6,094.00 / $10,413.00