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Washington rates for HCPCS 0567T

Permanent fallopian tube occlusion with degradable biopolymer implant, transcervical approach, including transvaginal ultrasound

Facilitymedian $525 · 10th–90th $347–$5250%50%10th$525Professionalmedian $417 · 10th–90th $363–$6920%20%40%10th90th$417$500.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $812.83
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$346.74 / $524.81 / $524.81
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $354.81 / $363.08
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $426.58 / $691.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $707.95 / $1,621.81
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $416.87 / $676.08