| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Pacific Source
| Facility | $315.97 | $432.30 | $526.62 | |
Providence
| Professional | $356.51 | $356.51 | $595.76 |
Permanent fallopian tube occlusion with degradable biopolymer implant, transcervical approach, including transvaginal ultrasound
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Pacific Source
| Facility | $315.97 | $432.30 | $526.62 | |
Providence
| Professional | $356.51 | $356.51 | $595.76 |