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Prostate Radiation Spacer Placement, with Imaging

Massachusetts rates for HCPCS 55874

This procedure places a temporary spacer material between the prostate and the rectum before radiation therapy for prostate cancer, performed together with imaging guidance such as ultrasound or CT to confirm accurate placement. The spacer creates extra space to help shield the rectum from radiation exposure during treatment, and it is gradually absorbed by the body over the following months.

Rates data updated July 2026.

Facilitymedian $1,820 · 10th–90th $186$5,6230%10%10th90th$1,820Professionalmedian $3,162 · 10th–90th $174$9,1200%5%10%10th90th$3,162$50.0$200.0$1.0K$5.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$1,000.00
Median
$2,398.83
Typical High
$5,128.61
Aetna
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$3,162.28
Typical High
$7,585.78
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$56.23
Median
$5,370.32
Typical High
$14,791.08
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$2,344.23
Typical High
$9,549.93
BCBS
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$190.55
Typical High
$436.52
BCBS
Setting
Professional
Modifier
Global
Typical Low
$380.19
Median
$380.19
Typical High
$6,918.31
Cigna
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$575.44
Typical High
$7,943.28
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$85.11
Median
$181.97
Typical High
$3,311.31
Fallon Health
Setting
Professional
Modifier
Global
Typical Low
$2,238.72
Median
$3,981.07
Typical High
$6,456.54
Harvard Pilgrim
Setting
Facility
Modifier
Global
Typical Low
$3,090.30
Median
$6,918.31
Typical High
$15,488.17
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$3,801.89
Typical High
$9,332.54
Health New England
Setting
Facility
Modifier
Global
Typical Low
$954.99
Median
$10,715.19
Typical High
$10,715.19
Health New England
Setting
Professional
Modifier
Global
Typical Low
$512.86
Median
$512.86
Typical High
$512.86
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$56.23
Median
$5,370.32
Typical High
$14,791.08
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$2,344.23
Typical High
$9,549.93
United
Setting
Facility
Modifier
Global
Typical Low
$3,090.30
Median
$7,244.36
Typical High
$15,488.17
United
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$3,311.31
Typical High
$9,332.54