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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
$1,258.93 / $7,943.28 / $37,153.52
Aetna
Facility/Professional
Facility
Modifier
22
Low / Median / High Price
$9,772.37 / $9,772.37 / $9,772.37
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,258.93 / $1,621.81 / $2,089.30
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.67 / $2,089.30 / $2,089.30
Cigna
Facility/Professional
Facility
Modifier
22
Low / Median / High Price
$2,511.89 / $2,511.89 / $2,511.89
Cigna
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$208.93 / $208.93 / $208.93
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22,387.21 / $41,686.94 / $52,480.75
Highmark BCBS
Facility/Professional
Facility
Modifier
22
Low / Median / High Price
$23,442.29 / $23,442.29 / $23,442.29
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,466.84 / $4,466.84 / $29,512.09