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Tennessee rates for HCPCS 57295

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$898.13 / $2,678.00 / $7,602.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,364.00 / $4,002.00 / $5,959.00
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $9,496.40 / $9,496.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,695.00 / $3,616.00 / $6,285.00