go back

Michigan rates for HCPCS 57300

Closure of rectovaginal fistula; vaginal or transanal approach

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,073.80 / $4,073.80 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.81 / $602.56 / $977.24
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$154.88 / $154.88 / $575.44
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.97 / $912.01 / $977.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.81 / $645.65 / $1,023.29
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$724.44 / $4,073.80 / $5,754.40
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.54 / $676.08 / $1,000.00
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562.34 / $645.65 / $954.99
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,511.89 / $5,011.87 / $8,912.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562.34 / $691.83 / $954.99