go back

New York rates for HCPCS 58740

Lysis of adhesions (salpingolysis, ovariolysis)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,138.17 / $5,167.00 / $11,161.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,100.00 / $7,264.00 / $12,697.00
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,274.66 / $1,274.66 / $37,499.62
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,030.02 / $1,030.02 / $7,227.90
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$319.00 / $962.40 / $2,381.71
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$555.00 / $1,030.02 / $7,227.90
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,031.00 / $4,840.00 / $9,202.00
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,031.58 / $1,031.58 / $2,927.91