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Montana rates for HCPCS 58953

Bilateral salpingo-oophorectomy with omentectomy, total abdominal hysterectomy and radical dissection for debulking;

Insurance Carrier
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,169.52 / $3,169.52 / $3,169.52
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,557.64 / $3,396.25 / $3,583.11