go back

Louisiana 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
$758.58 / $2,041.74 / $4,570.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $275.42 / $416.87
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,454.71 / $4,570.88 / $6,606.93
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$275.42 / $331.13 / $398.11
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.81 / $39.81 / $39.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$229.09 / $323.59 / $446.68
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$831.76 / $2,630.27 / $6,606.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $302.00 / $478.63