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Pennsylvania 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
$954.99 / $5,754.40 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$912.01 / $1,071.52 / $2,137.96
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20,417.38 / $21,379.62 / $57,543.99
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,659.59 / $1,659.59 / $1,659.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,318.26 / $2,137.96
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,122.02 / $1,445.44 / $1,621.81
Geisinger
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $1,318.26 / $2,041.74
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$954.99 / $4,265.80 / $8,317.64
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$912.01 / $1,258.93 / $2,951.21
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,288.25 / $1,288.25 / $2,187.76
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,096.48 / $1,659.59 / $2,290.87
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,047.13 / $1,047.13 / $1,148.15
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $1,071.52 / $1,096.48
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,137.96 / $3,090.30 / $6,025.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.99 / $1,258.93 / $2,137.96