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Maine rates for HCPCS 58671

Laparoscopy, surgical; with occlusion of oviducts by device (eg, band, clip, or Falope ring)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.59 / $407.38 / $660.69
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.00 / $501.19 / $707.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.58 / $512.86 / $831.76
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.87 / $501.19 / $741.31
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.59 / $398.11 / $1,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.08 / $512.86 / $812.83