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South Carolina rates for HCPCS 58740

Lysis of adhesions (salpingolysis, ovariolysis)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,344.23 / $10,000.00 / $18,197.01
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,737.80 / $1,737.80 / $3,801.89
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$776.25 / $1,202.26 / $1,995.26
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $10,964.78 / $16,982.44