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Texas rates for HCPCS 58740

Lysis Of Adhesions Salpinx/Ovary

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$942.00 / $3,669.00 / $12,040.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$887.71 / $1,481.91 / $5,513.44
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$807.20 / $807.20 / $807.20
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $55.00 / $7,198.87
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$862.24 / $1,143.32 / $1,951.33
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$872.52 / $1,162.99 / $2,223.42
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,154.00 / $3,314.00 / $7,600.00