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Utah 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
$3,467.37 / $10,000.00 / $13,803.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,182.57 / $13,182.57 / $13,182.57
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14,791.08 / $17,378.01 / $38,904.51
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,513.56 / $1,862.09 / $2,691.53
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,466.84 / $13,182.57 / $15,135.61