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Idaho rates for HCPCS 58573

Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,221.80 / $20,399.83 / $24,430.45
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,413.01 / $2,116.00 / $2,708.48
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,710.47 / $23,146.31 / $31,188.68
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,800.00 / $26,422.00 / $29,092.00