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West Virginia 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
$1,400.00 / $7,876.32 / $33,179.50
Aetna
Facility/Professional
Facility
Modifier
22
Low / Median / High Price
$9,691.20 / $9,691.20 / $9,691.20
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,168.56 / $1,577.56 / $1,928.12
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,393.58 / $1,393.58 / $1,393.58
Cigna
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$136.90 / $136.90 / $136.90
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21,338.46 / $45,764.19 / $50,262.89
Highmark BCBS
Facility/Professional
Facility
Modifier
22
Low / Median / High Price
$23,250.43 / $23,250.43 / $23,250.43