| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $200.01 | $418.09 | $418.09 | |
Medica
| Professional | $92.39 | $266.48 | $834.02 |
Introduction of mixture of saline and air for sonosalpingography to confirm occlusion of fallopian tubes, transcervical approach, including transvaginal ultrasound and pelvic ultrasound
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $200.01 | $418.09 | $418.09 | |
Medica
| Professional | $92.39 | $266.48 | $834.02 |