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South Carolina 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
$645.65 / $9,120.11 / $16,595.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.80 / $257.04 / $524.81
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,819.70 / $4,365.16 / $8,128.31
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.78 / $309.03 / $478.63
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,137.96 / $2,137.96 / $2,754.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.15 / $331.13 / $549.54
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$239.88 / $354.81 / $691.83
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $33.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,754.23 / $11,220.18 / $16,982.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.78 / $295.12 / $478.63