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Michigan rates for HCPCS 58140

Myomectomy, excision of fibroid tumor(s) of uterus, 1 to 4 intramural myoma(s) with total weight of 250 g or less and/or removal of surface myomas; abdominal approach

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,114.22 / $4,933.00 / $9,598.66
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$813.63 / $1,001.19 / $1,708.34
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,256.06 / $4,968.10 / $6,767.92
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$243.96 / $862.43 / $1,724.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$829.65 / $1,016.46 / $1,912.93
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$967.85 / $4,933.00 / $6,906.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$916.56 / $1,046.04 / $1,708.34
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.78 / $763.16 / $1,164.49
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,296.00 / $7,849.00 / $9,202.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$989.46 / $1,198.20 / $1,525.84