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Missouri rates for HCPCS 57296

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,110.00 / $4,470.00 / $12,154.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$737.59 / $915.89 / $1,042.53
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,224.00 / $4,490.00 / $10,961.39
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$888.39 / $1,102.56 / $1,812.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$818.99 / $1,413.09 / $2,287.58
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$658.30 / $1,394.88 / $6,890.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$988.86 / $1,413.69 / $8,328.64
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,185.00 / $3,233.00 / $11,343.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$939.42 / $1,305.28 / $2,640.93