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Tennessee 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
$1,751.05 / $6,809.40 / $22,725.78
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,512.00 / $7,194.00 / $13,734.00
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,897.00 / $27,770.10 / $27,770.10
Lucent Health
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$308.48 / $2,632.21 / $2,632.21
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,964.00 / $8,273.00 / $12,407.00