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Utah rates for HCPCS 58565

Hysteroscopy, surgical; with bilateral fallopian tube cannulation to induce occlusion by placement of permanent implants

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,398.83 / $6,309.57 / $7,943.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.58 / $1,380.38 / $2,398.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,309.57 / $6,309.57 / $6,309.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $1,621.81 / $3,019.95
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $1,148.15
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,244.36 / $8,511.38 / $19,498.45
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $954.99 / $3,630.78
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.78 / $1,513.56 / $3,630.78
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $2,041.74 / $3,235.94
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,466.84 / $6,309.57 / $13,803.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.58 / $1,479.11 / $3,235.94