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Utah 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
$3,162.28 / $6,025.60 / $10,964.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $5,495.41 / $9,549.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$912.01 / $5,623.41 / $10,232.93
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $3,981.07
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,803.84 / $16,218.10 / $36,307.81
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $1,698.24 / $11,220.18
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $5,370.32 / $15,135.61
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $7,079.46 / $11,220.18
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,311.31 / $5,128.61 / $26,915.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.58 / $1,659.59 / $10,964.78