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North Carolina rates for HCPCS 58740

Lysis of adhesions (salpingolysis, ovariolysis)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$888.97 / $3,875.00 / $10,087.00
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$868.75 / $1,203.00 / $2,132.87
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,526.00 / $7,659.00 / $10,502.00
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $5,880.14 / $7,198.87