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Indiana rates for HCPCS 58350

Chromotubation of oviduct, including materials

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$93.92 / $834.00 / $11,093.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.31 / $101.73 / $178.05
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,473.00 / $7,200.00 / $15,727.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.14 / $109.01 / $169.29
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$90.60 / $130.47 / $191.87
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$137.77 / $168.84 / $243.12
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,982.66 / $2,982.66 / $2,982.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.57 / $121.09 / $222.51
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,932.00 / $8,025.00 / $11,038.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.16 / $130.63 / $207.83