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Ohio rates for HCPCS 58301

Removal of intrauterine device (IUD)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$114.58 / $636.75 / $4,275.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.66 / $112.91 / $233.10
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.09 / $64.09 / $121.37
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$937.00 / $1,927.00 / $3,943.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.94 / $99.88 / $171.23
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$62.83 / $78.54 / $93.32
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$111.25 / $131.47 / $232.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21,571.00 / $21,571.00 / $21,571.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$76.70 / $122.15 / $200.48
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$86.20 / $576.44 / $1,701.09
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.54 / $131.47 / $201.75
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.34 / $115.47 / $157.15
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$444.00 / $979.00 / $3,218.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.27 / $131.28 / $242.35