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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
$1,358.00 / $15,283.79 / $40,457.76
Aetna
Facility/Professional
Facility
Modifier
22
Low / Median / High Price
$17,768.95 / $17,768.95 / $17,768.95
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,575.00 / $26,869.00 / $45,778.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,097.19 / $1,426.35 / $1,645.79
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,561.47 / $6,561.47 / $6,561.47
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,431.00 / $12,296.00 / $17,380.00