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Virginia rates for HCPCS 58263

Vag Hyst 250 Gm/< W/Rmvl Tube Ovary W/Rpr Ntrcl

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,099.94 / $5,412.00 / $11,025.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,153.00 / $7,363.00 / $9,410.00
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$942.05 / $1,130.46 / $1,394.23
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$936.21 / $1,316.16 / $1,888.90
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$991.03 / $1,307.93 / $5,122.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,303.00 / $9,373.00 / $17,192.00