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Wisconsin rates for HCPCS 58615

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

Facilitymedian $4,898 · 10th–90th $2,754$7,9430%10%10th90th$4,898Professionalmedian $331 · 10th–90th $234$9770%10%10th90th$331$50.0$200.0$1.0K$5.0K

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
$275.42 / $512.86 / $14,454.40
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $275.42 / $630.96
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,311.31 / $4,786.30 / $7,585.78
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $489.78 / $1,148.15
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $758.58 / $1,230.27
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $758.58 / $870.96
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$275.42 / $4,168.69 / $7,413.10
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $616.60 / $776.25
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$295.12 / $5,623.41 / $8,317.64
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $467.74 / $1,202.26
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $323.59
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $5,754.40 / $7,762.47
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $630.96 / $776.25
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $575.44 / $794.33
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,456.54 / $9,549.93 / $9,549.93
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $1,318.26 / $2,818.38
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $630.96 / $630.96
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $1,348.96 / $1,380.38
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,897.79 / $7,585.78 / $9,120.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $436.52 / $1,047.13