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Utah rates for HCPCS 58674

Laparoscopy, surgical, ablation of uterine fibroid(s) including intraoperative ultrasound guidance and monitoring, radiofrequency

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,162.28 / $6,025.60 / $9,332.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $831.76 / $1,659.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $1,096.48 / $1,778.28
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $3,801.89
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14,791.08 / $17,378.01 / $38,904.51
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.52 / $1,348.96 / $1,548.82
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $1,288.25 / $1,698.24
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $1,258.93 / $1,905.46
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,019.95 / $5,128.61 / $15,848.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $954.99 / $1,698.24