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Michigan 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
$1,584.89 / $9,772.37 / $23,988.33
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$363.08 / $1,819.70 / $1,819.70
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,584.89 / $9,772.37 / $23,988.33
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,011.87 / $10,000.00 / $21,379.62