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Texas rates for HCPCS 58740

Lysis of adhesions (salpingolysis, ovariolysis)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,047.13 / $3,715.35 / $12,882.50
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$912.01 / $1,548.82 / $5,495.41
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$812.83 / $812.83 / $812.83
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.95 / $56.23 / $7,244.36
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$851.14 / $1,348.96 / $5,248.07
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$812.83 / $1,148.15 / $2,041.74
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,288.25 / $4,073.80 / $8,709.64