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Indiana rates for HCPCS 0655T

Transperineal focal laser ablation of malignant prostate tissue, including transrectal imaging guidance, with MR-fused images or other enhanced ultrasound imaging

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,029.35 / $3,500.00 / $7,212.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$960.29 / $1,029.35 / $1,466.28
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,614.00 / $9,200.00 / $18,942.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.57 / $43.42 / $53.39
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,389.99 / $1,528.99 / $23,608.60
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,389.99 / $1,459.49 / $127,573.72
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,379.37 / $3,379.37 / $3,379.37
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.12 / $1.32 / $1.32
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,364.00 / $6,094.00 / $10,413.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,530.30 / $1,935.22 / $3,215.21