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Idaho rates for HCPCS 58740

Lysis of adhesions (salpingolysis, ovariolysis)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,415.00 / $4,500.00 / $8,439.00
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,054.94 / $1,561.92 / $1,772.78
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,550.00 / $12,152.00 / $12,233.00