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Illinois rates for HCPCS 57400

Dilation Vagina W/Anesthesia Other Than Local

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$169.19 / $1,486.00 / $5,091.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.40 / $128.79 / $245.92
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,297.66 / $2,816.52 / $5,402.48
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$160.38 / $215.70 / $254.36
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$620.00 / $620.00 / $643.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$142.10 / $190.47 / $273.30
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$155.19 / $225.74 / $681.20
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.59 / $166.43 / $183.42
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $211.64
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$930.00 / $3,951.00 / $6,625.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$142.15 / $192.43 / $347.72