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Wisconsin rates for HCPCS 38573

Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling, peritoneal washings, peritoneal biopsy(ies), omentectomy, and diaphragmatic washings, including diaphragmatic and other serosal biopsy(ies), when performed

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,096.48 / $2,398.83 / $14,454.40
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,882.50 / $18,197.01 / $28,840.32
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,019.95 / $3,467.37 / $5,623.41
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,071.52 / $1,445.44 / $8,912.51
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,071.52 / $1,479.11 / $14,125.38
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,412.54 / $2,511.89 / $3,981.07
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18,620.87 / $18,620.87 / $27,542.29
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,912.51 / $13,803.84 / $17,782.79