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Maryland 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
$2,053.06 / $8,297.75 / $13,229.46
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,162.83 / $5,162.83 / $5,162.83
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,266.01 / $1,633.15 / $2,703.37