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Michigan rates for HCPCS 57415

Removal of impacted vaginal foreign body (separate procedure) under anesthesia (other than local)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,884.03 / $2,884.03 / $4,897.79
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$165.96 / $263.03 / $263.03
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$204.17 / $2,884.03 / $4,897.79
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,511.89 / $5,011.87 / $8,912.51