go back

Illinois rates for HCPCS 58740

Lysis Of Adhesions Salpinx/Ovary

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$906.33 / $2,784.00 / $7,123.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,544.25 / $11,859.36 / $23,748.36
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$875.00 / $875.00 / $908.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$978.93 / $1,512.90 / $3,311.68
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$930.00 / $3,951.00 / $6,625.00