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Utah 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
$1,380.38 / $3,388.44 / $6,025.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,071.52 / $1,862.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $1,412.54 / $2,238.72
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $1,862.09
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,412.54 / $1,862.09 / $2,290.87
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$912.01 / $1,698.24 / $2,238.72
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,348.96 / $1,659.59 / $2,344.23
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,137.96 / $5,128.61 / $8,317.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.24 / $1,202.26 / $2,238.72