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Washington rates for HCPCS 58615

Occlusion of fallopian tube(s) by device (eg, band, clip, Falope ring) vaginal or suprapubic approach

Facilitymedian $3,090 · 10th–90th $398–$18,6210%10%10th90th$3,090Professionalmedian $347 · 10th–90th $224–$7410%20%10th90th$347$20.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $7,943.28 / $20,892.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $295.12 / $630.96
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,754.40 / $8,317.64 / $16,982.44
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $489.78 / $645.65
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,398.83 / $2,398.83 / $3,981.07
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $537.03 / $776.25
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $588.84 / $7,943.28
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $562.34 / $3,162.28
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $56.23
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $489.78 / $512.86
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$346.74 / $346.74 / $346.74
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $537.03 / $741.31
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,754.40 / $8,709.64 / $16,982.44
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $501.19 / $691.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,691.53 / $10,232.93 / $18,620.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $380.19 / $691.83
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $302.00 / $467.74