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Wisconsin 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
$2,290.87 / $4,365.16 / $14,454.40
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,606.93 / $11,220.18 / $18,197.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,495.41 / $6,456.54 / $10,232.93
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,290.87 / $6,918.31 / $13,489.63
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,187.76 / $3,801.89 / $7,943.28
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,570.40 / $5,011.87 / $6,918.31
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,495.41 / $22,387.21 / $22,387.21
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,290.87 / $6,165.95 / $19,498.45