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New Jersey 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
$4,265.80 / $8,511.38 / $15,488.17
Aetna
Facility/Professional
Facility
Modifier
22
Low / Median / High Price
$9,120.11 / $9,120.11 / $9,120.11
Horizon BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20,892.96 / $33,884.42 / $52,480.75
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,786.30 / $10,000.00 / $25,118.86