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California rates for HCPCS 58267

Vaginal hysterectomy, for uterus 250 g or less; with colpo-urethrocystopexy (Marshall-Marchetti-Krantz type, Pereyra type) with or without endoscopic control

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,055.58 / $9,639.00 / $20,509.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$938.30 / $1,075.33 / $5,584.17
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,343.00 / $11,780.00 / $23,151.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,275.42 / $1,671.66 / $3,214.06
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.50 / $100.00 / $5,485.17
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$769.20 / $1,188.83 / $2,909.56
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,003.18 / $1,337.39 / $3,813.90
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,053.94 / $1,182.52 / $1,537.28
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,064.27 / $1,361.38 / $2,423.50
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $6,922.02 / $8,761.06
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,695.28 / $7,932.80 / $9,013.35
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,080.48 / $1,390.28 / $2,062.50
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,003.18 / $1,363.10 / $3,009.71
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,464.88 / $3,464.88 / $3,464.88
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,053.94 / $1,311.98 / $1,791.69
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,110.00 / $9,707.00 / $21,278.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$858.96 / $1,233.79 / $3,571.85