go back

Indiana rates for HCPCS 58572

Laparoscopy Total Hysterectomy Uterus >250 Gm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,018.57 / $4,846.00 / $14,483.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,575.00 / $26,869.00 / $45,778.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$957.03 / $1,219.74 / $1,407.39
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,561.47 / $6,561.47 / $6,561.47
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,431.00 / $12,296.00 / $17,380.00