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Montana 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
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,467.37 / $3,467.37 / $3,467.37
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,548.13 / $3,801.89 / $4,168.69
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,905.46 / $2,884.03 / $3,715.35