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Indiana 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
$281.84 / $4,897.79 / $11,220.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.78 / $251.19 / $630.96
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,265.80 / $8,709.64 / $11,220.18
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.19 / $346.74 / $537.03
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$239.88 / $251.19 / $281.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.19 / $354.81 / $645.65
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,691.53 / $6,025.60 / $10,715.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.42 / $281.84 / $446.68