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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
$1,965.00 / $4,094.00 / $7,467.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$221.68 / $246.99 / $1,315.37
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,763.75 / $6,598.50 / $10,860.55
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$216.80 / $289.07 / $361.34
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,084.43 / $3,084.43 / $3,084.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$226.40 / $306.52 / $526.97
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$240.96 / $330.30 / $3,770.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$224.44 / $286.58 / $2,806.88
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,343.00 / $3,339.00 / $5,838.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$224.44 / $267.88 / $487.90