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Nebraska rates for HCPCS 58740

Lysis Of Adhesions Salpinx/Ovary

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,463.36 / $10,506.16 / $21,899.37
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,992.68 / $9,476.87 / $17,790.50
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$823.49 / $1,441.11 / $7,382.76
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,496.00 / $1,986.89 / $2,798.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,217.00 / $6,451.00 / $7,934.00