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Wisconsin rates for HCPCS 58200

Total abdominal hysterectomy, including partial vaginectomy, with para-aortic and pelvic lymph node sampling, with or without removal of tube(s), with or without removal of ovary(s)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,439.72 / $2,733.28 / $14,482.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,084.00 / $12,066.00 / $18,603.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,444.08 / $4,024.68 / $6,491.67
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,340.26 / $1,625.24 / $5,203.35
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,439.72 / $2,668.60 / $7,700.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,340.26 / $1,625.24 / $5,203.35
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,647.45 / $4,088.07 / $4,815.51
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14,191.65 / $14,191.65 / $14,191.65
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,203.00 / $4,316.80 / $19,003.00