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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
$847.59 / $847.59 / $2,600.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$960.41 / $1,078.08 / $1,174.58
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,030.02 / $1,030.02 / $1,030.02