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Texas 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
$1,124.61 / $4,376.00 / $11,703.48
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,730.49 / $12,956.19 / $25,071.07
Baylor Scott & White
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,061.44 / $9,043.37 / $17,596.66
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$926.04 / $12,301.23 / $12,301.23
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,027.91 / $7,027.91 / $7,027.91
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $5,897.00 / $27,770.10
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$989.35 / $1,314.17 / $2,244.71
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$989.35 / $1,315.11 / $2,297.66
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,608.00 / $7,350.00 / $16,000.00