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New Jersey 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
$4,466.84 / $6,918.31 / $10,964.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.80 / $251.19 / $741.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.47 / $398.11 / $851.14
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.88 / $323.59 / $426.58
Horizon BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,456.54 / $10,232.93 / $16,218.10
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.17 / $288.40 / $602.56
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,951.21 / $6,606.93 / $10,964.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $309.03 / $524.81