Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
REMOVE CONTRACEPTIVE CAPSULE
Tacoma, WA
See all hospitals reporting CPT 11976 →Price type
Mary Bridge Children's Hospital’s median price of $850 is 8% above the median hospital's median price ($787), higher than 55% of the 1,815 hospitals reporting CPT 11976. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 8 payers, 15 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | ||||
|---|---|---|---|---|
| 1 | Molina apple health fee schedule · outpatient | $314.86 | $314.86 | $314.86 – $314.86 |
| 2 | UnitedHealthcare apple health fee schedule · outpatient | $340.04 | $340.04 | $340.04 – $340.04 |
| 3 | Aetna medadvantage fee schedule · outpatient | $834.20 | $834.20 | $834.20 – $834.20 |
| 4 | Regence medadvantage fee schedule · outpatient | $834.20 | $834.20 | $834.20 – $834.20 |
| 5 | UnitedHealthcare medadvantage hmo fee schedule · outpatient | $842.30 | $842.30 | $842.30 – $842.30 |
| 6 | Molina medadvantage fee schedule · outpatient | $850.40 | $850.40 | $850.40 – $850.40 |
| 7 | WellCare medadvantage fee schedule · outpatient | $850.40 | $850.40 | $850.40 – $850.40 |
| 8 | Ambetter coordinated care exchange fee schedule · outpatient | $1,118 | $1,118 | $1,118 – $1,118 |
| 9 | Premera hmo fee schedule · outpatient | $1,216 | $1,216 | $1,216 – $1,216 |
| 10 | Premera signature fee schedule · outpatient | $2,571 | $2,571 | $2,571 – $2,571 |
| 11 | Premera prime fee schedule · outpatient | $2,629 | $2,629 | $2,629 – $2,629 |
| 12 | Premera other commercial plans fee schedule · outpatient | $3,231 | $3,231 | $3,231 – $3,231 |
| 13 | Regence realvalue fee schedule · outpatient | $3,677 | $3,677 | $3,677 – $3,677 |
| 14 | Aetna all commercial plans fee schedule · outpatient | $4,813 | $4,813 | $4,813 – $4,813 |
| 15 | Kaiser hmo/ppo fee schedule · outpatient | $5,104 | $5,104 | $5,104 – $5,104 |
Last updated: Aug 27, 2026
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