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Montana rates for HCPCS 58345

Transcervical introduction of fallopian tube catheter for diagnosis and/or re-establishing patency (any method), with or without hysterosalpingography

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$286.64 / $302.64 / $1,498.03
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,000.00 / $81,499.99 / $94,999.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$459.02 / $459.02 / $459.02
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$459.02 / $459.02 / $459.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$312.97 / $459.02 / $460.94
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$225.19 / $494.00 / $520.54
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$279.18 / $418.81 / $604.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$388.69 / $487.93 / $803.82