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Maine 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
Professional
Modifier
Low / Median / High Price
$234.42 / $295.12 / $575.44
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $346.74 / $489.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$295.12 / $354.81 / $562.34
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$281.84 / $346.74 / $512.86
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.42 / $295.12 / $707.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.15 / $346.74 / $562.34