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South Dakota rates for HCPCS 58615

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

Facilitymedian $525 · 10th–90th $229–$4,3650%20%10th90th$525Professionalmedian $302 · 10th–90th $214–$7240%10%20%10th90th$302$200.0$500.0$1.0K$2.0K$5.0K

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
$229.09 / $3,548.13 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $251.19 / $302.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $575.44 / $724.44
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $467.74 / $645.65
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $446.68 / $2,818.38
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $549.54 / $562.34
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $512.86 / $512.86
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $416.87 / $489.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,691.53 / $2,691.53 / $6,606.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $478.63 / $676.08
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $562.34 / $588.84