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Indiana 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
$1,445.44 / $12,882.50 / $38,018.94
Aetna
Facility/Professional
Facility
Modifier
22
Low / Median / High Price
$17,782.79 / $17,782.79 / $17,782.79
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,413.10 / $36,307.81 / $52,480.75
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,122.02 / $1,412.54 / $1,584.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,230.27 / $1,698.24 / $2,454.71
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,128.61 / $11,220.18 / $17,378.01