| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $454.24 | $454.24 | $454.24 | |
Medica
| Professional | $1,651.71 | $1,651.71 | $1,651.71 |
Permanent fallopian tube occlusion with degradable biopolymer implant, transcervical approach, including transvaginal ultrasound
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $454.24 | $454.24 | $454.24 | |
Medica
| Professional | $1,651.71 | $1,651.71 | $1,651.71 |