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
Ord, NE
See all hospitals reporting CPT 58542 →Price type
Valley County Hospital’s median price of $934 is 91% below the median hospital's median price ($10.4k), higher than 10% of the 1,776 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: 8 payers, 13 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 | Bcbs Ne medicare advantage professional · fee schedule · both | $670 | $670 | — | — | — | $670 – $670 |
| 2 | Medica medicare advantage professional · fee schedule · both | $670 | $670 | — | — | — | $670 – $670 |
| 3 | UnitedHealthcare medicare advantage professional · fee schedule · both | $670 | $670 | — | — | — | $670 – $670 |
| 4 | Humana medicare advantage professional · fee schedule · both | $683 | $683 | — | — | — | $683 – $683 |
| 5 | WellCare medicare advantage/dual needs plan professional · fee schedule · both | $690 | $690 | — | — | — | $690 – $690 |
| 6 | Aetna medicare advantage professional · fee schedule · both | $703 | $703 | — | — | — | $703 – $703 |
| 7 | UnitedHealthcare managed medicaid professional · fee schedule · both | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 8 | Molina managed medicaid/chip professional · fee schedule · both | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 9 | Molina dual eligible plan professional · fee schedule · both | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 10 | Medica individual and family business plans professional · fee schedule · both | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 11 | Bcbs Ne commercial professional · case rate · both | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 12 | Medica commercial plans/care system products professional · fee schedule · both | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 13 | MultiPlan primary/complementary ppo professional · fee schedule · both | $2.2k | $2.2k | — | — | — | $2.2k – $2.2k |
Last updated: Jun 15, 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.