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Idaho 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
$2,897.00 / $4,500.00 / $7,761.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$296.83 / $300.66 / $442.73
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$353.73 / $428.46 / $483.43
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$293.52 / $439.84 / $511.17
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$406.69 / $431.34 / $492.96
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $350.50 / $440.95
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,781.66 / $7,272.33 / $9,472.49
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$392.32 / $392.32 / $476.64
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,550.00 / $12,152.00 / $12,233.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$261.29 / $353.50 / $514.04