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Tennessee rates for HCPCS 58340

Catheterization and introduction of saline or contrast material for saline infusion sonohysterography (SIS) or hysterosalpingography

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$194.64 / $1,285.44 / $3,515.73
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.49 / $132.62 / $330.00
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.30 / $130.08 / $223.91
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$108.00 / $148.00 / $1,676.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.90 / $128.19 / $316.17
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.07 / $98.11 / $176.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.77 / $132.41 / $355.66
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $593.23 / $593.23
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,062.73 / $1,970.70 / $2,976.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$296.00 / $814.00 / $2,495.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$143.28 / $199.62 / $469.59