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Alaska rates for HCPCS 58615

Occlusion of fallopian tube(s) by device (eg, band, clip, Falope ring) vaginal or suprapubic approach

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$758.58 / $10,964.78 / $16,595.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$229.09 / $281.84 / $1,202.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.76 / $831.76 / $831.76
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$251.19 / $338.84 / $1,659.59
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562.34 / $724.44 / $1,737.80
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $1,047.13 / $1,380.38
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$338.84 / $1,202.26 / $1,698.24
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $229.09 / $831.76
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.65 / $676.08 / $1,698.24