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Pennsylvania rates for HCPCS 58671

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$552.66 / $3,627.00 / $8,017.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$313.06 / $360.49 / $460.49
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$680.72 / $680.72 / $680.72
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,800.00 / $11,479.00 / $17,952.00
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.34 / $385.35 / $385.35
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.21 / $472.94 / $749.97
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$440.71 / $585.88 / $585.88
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,603.47 / $11,603.47 / $11,603.47
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$655.00 / $3,838.00 / $8,017.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$322.68 / $375.31 / $1,119.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.00 / $473.80 / $946.50
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$373.16 / $480.74 / $784.37
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$366.01 / $366.01 / $376.25
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.52 / $368.11 / $385.72
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,304.00 / $4,563.00 / $8,261.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$337.31 / $459.55 / $723.38