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Michigan rates for HCPCS 57330

Closure of vesicovaginal fistula; transvesical and vaginal approach

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$901.43 / $4,933.00 / $4,933.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$635.61 / $901.43 / $938.99
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,104.36 / $8,280.37 / $11,218.60
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$224.79 / $790.52 / $1,278.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$677.32 / $823.87 / $1,579.28
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$743.55 / $4,933.00 / $4,933.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$743.55 / $843.48 / $1,209.41
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.78 / $614.57 / $941.53
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,296.00 / $7,849.00 / $9,202.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$826.08 / $962.35 / $1,244.99