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South Dakota 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
$1,735.39 / $1,735.39 / $17,639.59
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,904.92 / $2,743.33 / $3,941.47
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,414.12 / $4,754.82 / $5,982.74
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,353.92 / $3,305.11 / $3,768.19
Sanford Health Plan
Facility/Professional
Professional
Modifier
AS
Low / Median / High Price
$700.45 / $700.45 / $700.45
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,143.00 / $3,143.00 / $3,143.00