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Montana rates for HCPCS 55874

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

Facilitymedian $4,898 · 10th–90th $275–$7,0790%20%10th90th$4,898Professionalmedian $759 · 10th–90th $170–$6,1660%10%10th90th$759$100.0$500.0$2.0K$10.0K$50.0K

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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,737.80 / $1,819.70 / $5,370.32
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $758.58 / $6,025.60
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46,773.51 / $75,857.76 / $95,499.26
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $257.04 / $4,466.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $257.04 / $257.04
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $257.04 / $4,570.88
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$275.42 / $4,897.79 / $6,165.95
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $4,897.79 / $6,165.95
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $263.03 / $5,248.07
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $257.04 / $5,248.07
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,570.88 / $4,570.88 / $10,964.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $630.96 / $6,918.31