go back

South Dakota 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
$229.09 / $3,548.13 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.93 / $234.42 / $416.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.54 / $575.44 / $724.44
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$309.03 / $389.05 / $645.65
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.42 / $446.68 / $2,818.38
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $549.54 / $562.34
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $512.86 / $512.86
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$295.12 / $416.87 / $489.78
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,691.53 / $2,691.53 / $2,691.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.15 / $457.09 / $676.08
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.63 / $562.34 / $588.84