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North Carolina 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
$1,903.52 / $6,069.95 / $12,491.03
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,822.77 / $2,528.54 / $4,000.44
Medcost
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$309.87 / $354.00 / $669.97
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,366.00 / $9,541.00 / $14,589.00
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $12,534.34 / $15,392.44
Wellcare
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$436.12 / $950.04 / $950.04