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Minnesota 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
$229.09 / $229.09 / $5,011.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$229.09 / $275.42 / $426.58
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,445.44 / $6,165.95 / $14,454.40
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.05 / $575.44 / $933.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$645.65 / $912.01 / $2,187.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $776.25 / $1,174.90
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$707.95 / $870.96 / $1,737.80
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.74 / $660.69 / $977.24
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$302.00 / $501.19 / $7,762.47
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$309.03 / $512.86 / $1,380.38
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,884.03 / $5,248.07 / $8,912.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$295.12 / $512.86 / $1,000.00