go back

Michigan rates for HCPCS 58740

Lysis Of Adhesions Salpinx/Ovary

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,075.03 / $4,933.00 / $5,757.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,099.89 / $4,785.81 / $6,519.59
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$921.93 / $4,933.00 / $5,757.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,524.00 / $5,819.00 / $8,339.00