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Maine rates for HCPCS 57296

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $1,096.48 / $2,137.96
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17,782.79 / $18,620.87 / $25,118.86
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.14 / $1,348.96 / $1,819.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $1,230.27 / $2,137.96
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $1,288.25 / $1,905.46
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $1,122.02 / $2,691.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,318.26 / $1,905.46