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Pennsylvania rates for HCPCS 58615

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

Facilitymedian $4,786 · 10th–90th $1,047–$8,3180%10%10th90th$4,786Professionalmedian $251 · 10th–90th $214–$5750%20%40%10th90th$251$10.0$50.0$200.0$1.0K$5.0K$20.0K

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
Facility
Modifier
Typical Low / Median / Typical High
$1,047.13 / $4,786.30 / $8,317.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $251.19 / $645.65
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $5,248.07 / $57,543.99
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $251.19 / $389.05
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $323.59 / $478.63
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $354.81 / $389.05
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $323.59 / $489.78
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$831.76 / $3,715.35 / $8,317.64
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $251.19 / $1,122.02
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $380.19 / $524.81
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $251.19 / $912.01
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $275.42 / $912.01
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,659.59 / $3,981.07 / $10,471.29
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $295.12 / $501.19