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Tennessee rates for HCPCS 57426

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,150.00 / $3,329.00 / $7,602.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,984.00 / $5,486.00 / $9,419.00
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $17,704.40 / $17,704.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,259.00 / $4,567.00 / $7,669.00