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South Carolina rates for HCPCS 58350

Chromotubation Oviduct W/Materials

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$130.80 / $5,365.52 / $10,032.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.31 / $104.64 / $240.08
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,232.15 / $7,593.41 / $13,640.30
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.62 / $113.37 / $166.53
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,831.77 / $2,831.77 / $3,638.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.00 / $128.43 / $281.80
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$90.12 / $135.00 / $234.11
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,623.64 / $2,505.44 / $3,009.60
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.73 / $149.65 / $230.16
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,114.00 / $13,190.00 / $23,771.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.33 / $153.33 / $326.51