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Wisconsin 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
$812.83 / $6,456.54 / $22,387.21
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.58 / $3,388.44 / $9,549.93
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,882.50 / $17,378.01 / $28,840.32
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,202.26 / $6,025.60 / $23,442.29
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15,488.17 / $18,197.01 / $28,840.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.27 / $2,754.23 / $20,892.96
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$891.25 / $5,128.61 / $9,772.37
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,621.81 / $2,511.89 / $16,218.10
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$891.25 / $9,549.93 / $19,952.62
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,819.70 / $12,022.64 / $41,686.94
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $2,344.23
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,348.96 / $6,309.57 / $19,498.45
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26,915.35 / $38,904.51 / $38,904.51
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $11,748.98 / $38,904.51
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,630.27 / $19,498.45 / $28,183.83
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,709.64 / $16,982.44 / $22,387.21
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$912.01 / $3,715.35 / $23,988.33