go back

Wisconsin 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
$1,068.53 / $2,009.18 / $14,482.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,538.00 / $9,720.00 / $15,579.70
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,542.06 / $2,970.60 / $4,791.47
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$993.89 / $1,206.30 / $4,298.43
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,068.53 / $4,298.43 / $12,622.22
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$993.89 / $1,206.30 / $4,298.43
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,946.75 / $2,995.97 / $3,540.99
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,899.50 / $10,899.50 / $10,899.50
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,073.00 / $9,837.00 / $12,062.00