go back

Arizona 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
$2,187.76 / $4,168.69 / $7,762.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.80 / $275.42 / $741.31
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,659.59 / $5,370.32 / $7,943.28
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$288.40 / $323.59 / $933.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,090.30 / $3,090.30 / $3,090.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.42 / $309.03 / $524.81
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$245.47 / $371.54 / $5,011.87
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $288.40 / $2,818.38
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,238.72 / $3,162.28 / $5,370.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.78 / $263.03 / $501.19