Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
LSH W/T/O UT 250 G OR LESS
Long Beach, CA
See all hospitals reporting CPT 58542 →Price type
Dignity Health’s median price of $12.1k is 17% above the median hospital's median price ($10.4k), higher than 72% of the 1,764 hospitals reporting CPT 58542. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 7 payers, 16 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Anthem medicaid|all plans fee schedule · outpatient | $699 | $699 | — | — | — | $699 – $699 |
| 2 | Molina medicaid|all plans fee schedule · outpatient | $978 | $978 | — | — | — | $978 – $978 |
| 3 | Kaiser medicaid|< 21 fee schedule · outpatient | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 4 | Kaiser medicaid|> 21 fee schedule · outpatient | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 5 | Blue Cross Blue Shield medicaid|all plans fee schedule · outpatient | $3.5k | $3.5k | — | — | — | $3.5k – $3.5k |
| 6 | Anthem commercial|exchange case rate · outpatient | $6.8k | $6.8k | — | — | — | $6.8k – $6.8k |
| 7 | Anthem commercial|all other plans case rate · outpatient | $10.2k | $10.2k | — | — | — | $10.2k – $10.2k |
| 8 | Anthem medicare|all plans fee schedule · outpatient | $13.2k | $13.2k | — | — | — | $13.2k – $13.2k |
| 9 | Blue Cross Blue Shield medicare|all other plans case rate · outpatient | $13.2k | $13.2k | — | — | — | $13.2k – $13.2k |
| 10 | Cigna medicare|all plans fee schedule · outpatient | $13.2k | $13.2k | — | — | — | $13.2k – $13.2k |
| 11 | Humana medicare|all plans fee schedule · outpatient | $13.2k | $13.2k | — | — | — | $13.2k – $13.2k |
| 12 | Kaiser medicare|all plans fee schedule · outpatient | $13.2k | $13.2k | — | — | — | $13.2k – $13.2k |
| 13 | Molina medicare|all plans fee schedule · outpatient | $13.2k | $13.2k | — | — | — | $13.2k – $13.2k |
| 14 | UnitedHealthcare medicare|all plans fee schedule · outpatient | $13.5k | $13.5k | — | — | — | $13.5k – $13.5k |
| 15 | Anthem commercial|mcs case rate · outpatient | $15.8k | $15.8k | — | — | — | $15.8k – $15.8k |
| 16 | Blue Cross Blue Shield medicare|trauma fee schedule · outpatient | $16.5k | $16.5k | — | — | — | $16.5k – $16.5k |
Last updated: Feb 28, 2026
See Laparoscopic hysterectomy with removal of tubes and/or ovaries pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.