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Arizona rates for HCPCS 55874

Transperineal placement of biodegradable material, peri-prostatic, single or multiple injection(s), including image guidance, when performed

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,162.00 / $2,956.00 / $7,562.14
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$166.28 / $3,037.55 / $7,714.13
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$672.35 / $2,531.19 / $4,140.09
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$152.08 / $1,007.72 / $2,860.17
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,191.77 / $7,191.77 / $7,191.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$170.26 / $453.75 / $5,878.93
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$171.74 / $2,838.84 / $7,899.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,058.93 / $4,219.20 / $10,269.87
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,255.00 / $7,205.00 / $11,396.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,873.96 / $3,771.65 / $6,328.80