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Arizona rates for HCPCS 58575

Laparoscopy, surgical, total hysterectomy for resection of malignancy (tumor debulking), with omentectomy including salpingo-oophorectomy, unilateral or bilateral, when performed

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$936.00 / $3,617.00 / $7,562.14
Aetna
Facility/Professional
Facility
Modifier
22
Low / Median / High Price
$6,141.00 / $6,141.00 / $6,141.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,763.75 / $6,598.50 / $10,860.55
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,796.31 / $2,578.79 / $6,117.00
Medica
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$489.99 / $881.80 / $881.80
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,878.00 / $4,545.00 / $7,217.00