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Indiana rates for HCPCS 58954

Bilateral salpingo-oophorectomy with omentectomy, total abdominal hysterectomy and radical dissection for debulking; with pelvic lymphadenectomy and limited para-aortic lymphadenectomy

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,117.16 / $2,400.52 / $4,846.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,091.00 / $15,450.00 / $23,392.06
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,990.67 / $2,537.13 / $2,927.46
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,403.00 / $5,242.00 / $10,843.00