go back

Wisconsin rates for HCPCS 57400

Dilation of vagina under anesthesia (other than local)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.04 / $263.03 / $14,454.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.82 / $138.04 / $446.68
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,311.31 / $4,786.30 / $7,585.78
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.82 / $245.47 / $588.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$331.13 / $389.05 / $616.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $389.05 / $436.52
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.04 / $3,019.95 / $5,370.32
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$229.09 / $316.23 / $389.05
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.04 / $5,495.41 / $8,317.64
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.83 / $239.88 / $1,071.52
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $177.83
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.36 / $295.12 / $416.87
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,456.54 / $9,549.93 / $9,549.93
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $630.96 / $1,071.52
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$316.23 / $316.23 / $316.23
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$281.84 / $691.83 / $707.95
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,897.79 / $7,413.10 / $9,120.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $204.17 / $549.54