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Tennessee 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
$707.95 / $2,454.71 / $6,456.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.80 / $275.42 / $446.68
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,137.96 / $4,073.80 / $5,888.44
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$275.42 / $363.08 / $575.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,187.76 / $2,187.76 / $2,187.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.42 / $338.84 / $549.54
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.95 / $9,549.93 / $9,549.93
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,818.38 / $2,818.38 / $2,818.38
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,041.74 / $3,630.78 / $6,309.57
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.42 / $338.84 / $512.86