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New Hampshire 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
$100.00 / $2,398.83 / $9,772.37
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,890.45 / $17,782.79 / $28,183.83
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,000.00 / $10,000.00 / $10,000.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,000.00 / $10,000.00 / $10,000.00