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Montana rates for HCPCS 58615

Occlusion of fallopian tube(s) by device (eg, band, clip, Falope ring) vaginal or suprapubic approach

Facilitymedian $447 · 10th–90th $407–$8,7100%50%10th90th$447Professionalmedian $316 · 10th–90th $234–$7940%20%10th90th$316$100.0$500.0$2.0K$10.0K$50.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $302.00 / $794.33
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46,773.51 / $75,857.76 / $95,499.26
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$407.38 / $407.38 / $407.38
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $407.38 / $407.38
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$416.87 / $446.68 / $501.19
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $446.68 / $501.19
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$223.87 / $338.84 / $457.09
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $288.40 / $575.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$295.12 / $295.12 / $6,606.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $416.87 / $707.95