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Maryland rates for HCPCS 57300

Closure of rectovaginal fistula; vaginal or transanal approach

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,296.17 / $6,296.17 / $6,296.17
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$518.86 / $552.29 / $992.99
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$626.86 / $647.29 / $716.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,765.51 / $1,765.51 / $1,765.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$518.94 / $756.79 / $1,593.62
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$638.78 / $824.03 / $1,368.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$486.38 / $711.25 / $1,198.57
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$502.38 / $734.60 / $905.13