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Montana rates for HCPCS 58662

Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,818.80 / $8,070.24 / $15,607.19
Aetna
Facility/Professional
Facility
Modifier
22
Low / Median / High Price
$31,789.15 / $31,789.15 / $31,789.15
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,000.00 / $81,499.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,131.00 / $1,131.00 / $1,131.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$555.17 / $1,242.15 / $1,309.91