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Montana rates for HCPCS 58943

Oophorectomy, partial or total, unilateral or bilateral; for ovarian, tubal or primary peritoneal malignancy, with para-aortic and pelvic lymph node biopsies, peritoneal washings, peritoneal biopsies, diaphragmatic assessments, with or without salpingectomy(s), with or without omentectomy

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,219.14 / $6,089.99 / $6,089.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,904.97 / $1,904.97 / $1,904.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,256.22 / $1,904.97 / $1,957.85
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$936.45 / $1,978.60 / $2,089.15
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,123.19 / $1,684.96 / $2,430.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,582.96 / $1,953.44 / $3,243.96