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Massachusetts rates for HCPCS 58740

Lysis of adhesions (salpingolysis, ovariolysis)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,570.40 / $3,715.35 / $6,456.54
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.23 / $2,570.40 / $7,244.36
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.44 / $1,778.28 / $7,079.46
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $4,265.80 / $9,772.37
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.23 / $2,630.27 / $7,244.36
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,288.25 / $3,801.89 / $9,120.11