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Ohio rates for HCPCS 58750

Tubotubal anastomosis

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,321.36 / $6,251.00 / $11,581.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$888.61 / $888.61 / $2,381.44
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,426.00 / $12,098.50 / $21,233.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$753.47 / $993.67 / $1,789.66
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$805.90 / $1,373.70 / $1,745.42
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,680.77 / $1,680.77 / $1,680.77
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21,571.00 / $21,571.00 / $21,571.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$788.01 / $1,206.71 / $1,816.39
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$861.93 / $1,269.68 / $1,816.39
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.62 / $836.96 / $1,242.54
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,840.00 / $5,998.00 / $7,847.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$841.56 / $1,189.15 / $1,936.02