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Pennsylvania rates for HCPCS 58548

Laparoscopy, surgical, with radical hysterectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy), with removal of tube(s) and ovary(s), if performed

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,426.00 / $3,964.00 / $9,534.00
Aetna
Facility/Professional
Facility
Modifier
52
Low / Median / High Price
$2,397.13 / $4,048.14 / $4,684.80
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,531.00 / $27,840.00 / $46,480.74
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,921.34 / $6,921.34 / $27,857.82
Highmark BCBS
Facility/Professional
Facility
Modifier
52
Low / Median / High Price
$21,911.29 / $21,911.29 / $21,911.29
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,020.00 / $4,761.00 / $9,534.00
Martin's Point
Facility/Professional
Facility
Modifier
52
Low / Median / High Price
$2,397.13 / $4,048.14 / $4,684.80
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,785.37 / $1,844.55 / $1,844.55
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,332.00 / $4,127.00 / $7,503.00