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Pennsylvania rates for HCPCS 58553

Laparoscopy, surgical, with vaginal hysterectomy, for uterus greater than 250 g;

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,013.00 / $5,254.00 / $11,022.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$930.84 / $1,062.70 / $1,684.50
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,639.91 / $11,851.00 / $28,970.26
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,119.52 / $1,770.69 / $2,520.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,078.49 / $1,454.33 / $2,266.53
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,319.70 / $1,754.55 / $1,754.55
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,291.56 / $6,291.56 / $6,291.56
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,301.00 / $5,742.00 / $11,938.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$930.84 / $1,175.31 / $4,654.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.00 / $1,318.20 / $2,813.10
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,081.25 / $1,458.86 / $2,490.75
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,103.57 / $1,103.57 / $1,247.82
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,065.10 / $1,113.93 / $1,247.82
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,304.00 / $4,563.00 / $8,261.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,079.19 / $1,368.84 / $2,406.14