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Illinois rates for HCPCS 57426

Revision Prosthetic Vaginal Graft Laparoscopic

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$923.00 / $2,835.50 / $7,123.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,272.65 / $11,177.32 / $20,202.43
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$875.00 / $875.00 / $908.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$935.26 / $1,487.92 / $3,744.20
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,152.00 / $4,803.00 / $8,995.00