go back

Maryland rates for HCPCS 58572

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$881.47 / $3,279.19 / $11,424.08
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,162.83 / $5,162.83 / $5,162.83
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,082.82 / $1,396.84 / $2,298.19