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Utah rates for HCPCS 59120

Surgical treatment of ectopic pregnancy; tubal or ovarian, requiring salpingectomy and/or oophorectomy, abdominal or vaginal approach

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$933.25 / $5,888.44 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $851.14 / $1,548.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $1,096.48 / $1,659.59
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $1,445.44
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.52 / $1,348.96 / $1,584.89
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $1,288.25 / $1,698.24
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $1,258.93 / $1,819.70
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,137.96 / $5,128.61 / $8,317.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$741.31 / $912.01 / $1,698.24