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Massachusetts 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
$1,778.28 / $3,311.31 / $5,128.61
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.80 / $251.19 / $758.58
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.23 / $2,884.03 / $9,549.93
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.15 / $389.05 / $2,818.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$281.84 / $478.63 / $851.14
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$234.42 / $489.78 / $7,079.46
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.90 / $263.03 / $389.05
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $4,265.80 / $9,772.37
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$275.42 / $436.52 / $707.95
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.23 / $3,801.89 / $9,549.93
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.15 / $389.05 / $2,818.38
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,862.09 / $4,265.80 / $9,772.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$281.84 / $398.11 / $954.99