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Pennsylvania rates for HCPCS 58350

Chromotubation Oviduct W/Materials

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$132.80 / $2,557.25 / $7,263.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.08 / $101.73 / $185.47
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,800.00 / $7,463.00 / $11,048.00
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$129.06 / $167.08 / $245.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.60 / $138.03 / $240.87
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$178.20 / $236.58 / $241.98
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,583.66 / $6,455.74 / $15,516.76
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$142.88 / $3,623.00 / $8,017.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.70 / $134.50 / $293.83
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.00 / $132.19 / $422.10
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.04 / $141.63 / $241.02
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.66 / $93.30 / $149.88
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.08 / $114.60 / $161.91
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,332.00 / $5,762.00 / $15,888.49
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$105.44 / $152.60 / $264.27