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South Dakota 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
$933.86 / $4,621.05 / $8,331.90
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,216.66 / $1,437.87 / $2,679.13
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,870.00 / $2,738.40 / $8,568.00
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,270.59 / $1,725.04 / $2,029.33
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,357.00 / $5,357.00 / $5,357.00