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Montana 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
$8,767.44 / $16,316.00 / $40,100.44
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,000.00 / $81,499.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,930.74 / $1,930.74 / $1,930.74
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$947.19 / $2,305.55 / $2,437.02