go back

Indiana rates for HCPCS 58750

Tubotubal anastomosis

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$894.74 / $1,386.00 / $16,042.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$795.96 / $894.74 / $1,065.16
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,091.00 / $15,450.00 / $23,392.06
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$913.03 / $1,176.73 / $1,623.88
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,252.38 / $1,596.18 / $1,964.52
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,148.01 / $1,473.39 / $1,534.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$937.34 / $1,142.84 / $1,944.71
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,932.00 / $8,025.00 / $11,038.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$860.32 / $1,025.98 / $1,748.98