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West Virginia 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
$3,950.40 / $15,835.24 / $52,385.26
Aetna
Facility/Professional
Facility
Modifier
22
Low / Median / High Price
$12,979.55 / $12,979.55 / $12,979.55
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$868.32 / $1,172.23 / $1,432.73
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,038.28 / $1,038.28 / $1,038.28
Cigna
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$102.27 / $102.27 / $102.27
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,001.93 / $32,973.56 / $53,013.22
Highmark BCBS
Facility/Professional
Facility
Modifier
22
Low / Median / High Price
$30,368.53 / $30,368.53 / $67,124.74