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Hawaii rates for HCPCS 58740

Lysis of adhesions (salpingolysis, ovariolysis)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,528.00 / $6,084.00 / $7,424.00
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$978.95 / $1,067.94 / $1,245.93
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,981.00 / $1,981.00 / $1,981.00