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West Virginia rates for HCPCS 58740

Lysis of adhesions (salpingolysis, ovariolysis)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$851.14 / $851.14 / $2,570.40
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$954.99 / $954.99 / $1,174.90
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.67 / $1,548.82 / $1,548.82
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,174.90 / $1,174.90 / $2,454.71