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Michigan 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
$1,235.94 / $4,933.00 / $8,468.73
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,797.88 / $9,102.48 / $12,400.08
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,213.32 / $4,933.00 / $6,906.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,000.00 / $10,359.00 / $12,767.00