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Indiana rates for HCPCS 58740

Lysis of adhesions (salpingolysis, ovariolysis)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,000.00 / $4,897.79 / $16,218.10
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,549.93 / $18,620.87 / $26,302.68
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$870.96 / $891.25 / $1,023.29
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$891.25 / $1,258.93 / $1,778.28
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,288.25 / $6,025.60 / $10,715.19