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Pennsylvania 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
$1,028.00 / $2,747.00 / $8,017.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$958.19 / $1,397.67 / $1,770.56
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,255.40 / $2,255.40 / $2,255.40
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$954.00 / $3,120.00 / $8,017.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$931.57 / $1,427.25 / $1,785.81
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.00 / $6.00 / $6.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,747.00 / $2,824.00 / $5,678.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,492.31 / $1,865.39 / $2,962.65