Banner Del E Webb Medical Center
Hospital
3.0
14502 West Meeker Boulevard, Sun City West, AZ 85375
How this provider stacks up
$4,515
This provider's rate
Lowest
$4,130
Highest
$10,205
This is this provider's self-pay (cash) rate. See how it compares to rates from other providers in this area.
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Hysteroscopy with Surgical Procedure Overview
This list includes the services and fees bundled into the Hysteroscopy with Surgical Procedure Standard Service Package (SSP RE003). The final price for the procedure will depend on which services your provider ultimately performs, your insurance plan and your medical benefits.
| Code | Code Type | Description |
|---|---|---|
| HCPCS 58563 | Base Code | Hysteroscopy with Surgical Procedure |
| HCPCS 58563 | Professional | Hysteroscopy with Surgical Procedure |
| RC 0710 | Facility | Recovery Room - General |
| RC 0370 | Facility | Anesthesia - General |
| HCPCS J3010 | Facility | Intramuscular injection of fentanyl citrate, 0.1mg |
| HCPCS J2405 | Facility | Intramuscular injection of ondansetron hydrochloride, 1mg |
| RC 0250 | Facility | Pharmacy (Also see 063X, an extension of 250X) - General |
| RC 0360 | Facility | Operating Room Services - General |
| HCPCS J2704 | Facility | Intramuscular injection of 10mg propofol |
| RC 0636 | Facility | Pharmacy - Extension of 025X - Drugs requiring detailed coding |
| HCPCS 88305 | Facility | Microscopic/gross-exam of surgical pathology biopsies/exam/resections |
| HCPCS J2250 | Facility | Intramuscular injection of 1mg midazolam hydrochloride |
| HCPCS J1100 | Facility | Intramuscular injection of 1mg dexamethasone sodium phosphate |
| RC 0272 | Facility | Medical/Surgical Supplies and Devices (Also see 062X, an extension of 027X) - Sterile |
| HCPCS J1885 | Facility | Intramuscular injection of 15mg ketorolac tromethamine |
| HCPCS J7120 | Facility | Intravenous infusion of 1000cc of ringer's lactate solution |
| RC 0270 | Optional | Medical/Surgical Supplies and Devices (Also see 062X, an extension of 027X) - General |
Your Right to Know (and Save)
The No Surprises Act requires healthcare providers to give you a cost estimate for certain services. We've made it easier by grouping common services into Standard Service Packages (SSPs), so you can see the typical services and costs that are usually bundled together. Here's how to use this estimate to avoid surprise bills and shop around confidently:
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