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Montana 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
$4,460.39 / $9,807.74 / $29,559.63
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,000.00 / $81,499.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,442.27 / $1,442.27 / $1,442.27
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$707.10 / $1,797.90 / $1,903.19