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Utah rates for HCPCS 58615

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

Facilitymedian $5,888 · 10th–90th $3,162–$8,9130%10%10th90th$5,888Professionalmedian $302 · 10th–90th $229–$5750%10%20%10th90th$302$50.0$200.0$1.0K$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
$316.23 / $5,888.44 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $251.19 / $575.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $323.59 / $537.03
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $501.19
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,570.88 / $6,165.95 / $9,549.93
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $416.87 / $512.86
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $398.11 / $575.44
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $371.54 / $446.68
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $5,128.61 / $7,079.46
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $302.00 / $524.81