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Indiana 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
$184.30 / $3,500.00 / $8,542.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$161.50 / $414.00 / $4,047.92
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,310.00 / $10,338.00 / $26,304.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$161.78 / $3,350.97 / $4,708.16
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$152.84 / $194.79 / $3,477.55
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,442.67 / $2,931.20 / $3,664.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,231.72 / $5,231.72 / $5,231.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$171.90 / $817.07 / $5,119.04
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,431.00 / $12,296.00 / $17,380.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,865.26 / $4,284.63 / $8,108.69