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Idaho rates for HCPCS 58571

Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,877.57 / $12,525.26 / $25,817.84
Aetna
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$602.53 / $602.53 / $602.53
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,054.54 / $1,577.79 / $2,070.32
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,710.47 / $23,146.31 / $31,188.68
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,800.00 / $26,422.00 / $29,092.00