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Washington rates for HCPCS 58573

Laparoscopy Tot Hysterectomy >250 G W/Tube/Ovar

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,548.13 / $24,741.18 / $56,394.26
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,897.00 / $27,770.10 / $55,801.25
Asuris Northwest Health
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$1,582.51 / $2,632.21 / $2,632.21
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,960.89 / $6,960.89 / $11,596.76
Kaiser Permanente
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,612.94 / $2,798.39 / $12,102.55
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,909.53 / $2,347.01 / $2,594.91
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,637.60 / $1,678.10 / $4,000.25
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18,916.23 / $29,070.27 / $55,801.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,028.00 / $4,686.00 / $20,708.00