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Utah rates for HCPCS 57308

Closure of rectovaginal fistula; transperineal approach, with perineal body reconstruction, with or without levator plication

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$831.76 / $3,388.44 / $6,025.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $645.65 / $1,148.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $870.96 / $1,445.44
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $1,258.93
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $1,148.15 / $4,073.80
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616.60 / $1,047.13 / $1,380.38
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.76 / $1,023.29 / $1,479.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $5,128.61 / $7,079.46
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $724.44 / $1,380.38