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Nebraska 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
$2,166.29 / $4,205.08 / $12,765.09
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.82 / $2,695.63 / $13,040.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,646.56 / $11,718.32 / $21,998.27
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$160.25 / $364.20 / $5,354.68
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$369.29 / $5,274.96 / $9,253.31
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$193.57 / $2,779.23 / $8,220.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,862.11 / $6,962.81 / $10,269.87
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$387.31 / $6,145.22 / $9,253.31
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$357.35 / $5,952.65 / $8,876.96
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.00 / $4,462.20 / $8,256.90
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,777.00 / $8,220.00 / $9,696.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,551.56 / $6,962.81 / $8,133.07