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Indiana rates for HCPCS 57426

Revision (including removal) of prosthetic vaginal graft, laparoscopic approach

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$857.96 / $1,386.00 / $16,042.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,646.00 / $24,214.00 / $45,778.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$804.25 / $1,025.02 / $1,182.72
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,183.17 / $4,183.17 / $4,183.17
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,932.00 / $8,025.00 / $11,038.00