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Indiana rates for HCPCS 58740

Lysis Of Adhesions Salpinx/Ovary

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$883.56 / $1,386.00 / $16,042.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,091.00 / $15,450.00 / $23,392.06
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$828.73 / $1,056.22 / $1,218.72
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,364.00 / $6,094.00 / $10,413.00