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California 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
$3,019.95 / $7,585.78 / $18,197.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $281.84 / $1,380.38
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,570.88 / $7,943.28 / $15,848.93
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.00 / $416.87 / $812.83
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.07 / $3,090.30 / $8,709.64
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.15 / $389.05 / $758.58
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,137.96 / $2,137.96 / $2,137.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.19 / $316.23 / $660.69
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.04 / $562.34 / $831.76
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $281.84 / $524.81
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.95 / $56.23 / $9,549.93
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,818.38 / $2,818.38 / $2,818.38
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.54 / $371.54 / $371.54
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$245.47 / $338.84 / $616.60
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.19 / $323.59 / $660.69
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $812.83 / $812.83
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.93 / $562.34 / $954.99
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,981.07 / $7,585.78 / $15,135.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.53 / $281.84 / $724.44