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Wisconsin 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
$190.55 / $354.81 / $14,454.40
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,311.31 / $4,786.30 / $7,585.78
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$457.09 / $537.03 / $851.14
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$186.21 / $3,019.95 / $5,370.32
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$186.21 / $5,495.41 / $8,317.64
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.17 / $398.11 / $549.54
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,456.54 / $9,549.93 / $9,549.93
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,897.79 / $7,413.10 / $9,120.11