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Missouri 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
$1,412.54 / $3,715.35 / $7,943.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.93 / $275.42 / $630.96
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,238.72 / $4,677.35 / $8,912.51
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.04 / $316.23 / $478.63
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $257.04 / $407.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.47 / $363.08 / $524.81
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.95 / $467.74 / $6,025.60
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.47 / $363.08 / $2,818.38
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,819.70 / $2,570.40 / $4,677.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.88 / $302.00 / $467.74