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Michigan rates for HCPCS 55873

Cryosurgical ablation of the prostate (includes ultrasonic guidance and monitoring)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,023.29 / $5,754.40 / $9,120.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.58 / $3,630.78 / $8,709.64
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$229.09 / $724.44 / $1,148.15
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$229.09 / $1,096.48 / $1,148.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $2,754.23 / $9,332.54
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,230.27 / $5,754.40 / $17,378.01
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.33 / $6,456.54 / $9,549.93
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $1,445.44 / $9,120.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,918.31 / $11,481.54 / $25,118.86
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $1,659.59 / $8,912.51