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Pennsylvania 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
$1,047.13 / $3,981.07 / $8,317.64
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,011.87 / $6,165.95 / $57,543.99
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,918.31 / $6,918.31 / $6,918.31
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$954.99 / $2,818.38 / $8,317.64
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$204.17 / $204.17 / $363.08
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.11 / $162.18 / $213.80
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,348.96 / $3,548.13 / $10,000.00