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Wisconsin rates for HCPCS 0567T

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

Facilitymedian $10,965 · 10th–90th $6,310–$18,1970%10%10th90th$10,965Professionalmedian $955 · 10th–90th $525–$1,6600%20%40%10th90th$955$100.0$500.0$2.0K$10.0K

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

Insurance Carrier
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,606.93 / $10,964.78 / $18,197.01
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $1,659.59 / $1,659.59
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $58.88 / $58.88
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $524.81 / $1,659.59
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $954.99 / $1,659.59
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,760.83 / $16,982.44 / $19,498.45
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $794.33 / $1,047.13