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Maine 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
$7,762.75 / $9,904.66 / $25,066.83
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,914.10 / $10,472.42 / $32,703.82