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New York 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
$240.42 / $4,509.81 / $11,715.06
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$166.28 / $757.06 / $6,658.30
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,100.00 / $7,264.00 / $12,274.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,026.44 / $2,613.89 / $8,185.39
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$231.82 / $231.82 / $16,534.50
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$231.82 / $231.82 / $4,465.85
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$279.11 / $279.11 / $13,296.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$184.05 / $663.88 / $9,878.16
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$145.49 / $235.69 / $414.56
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,851.57 / $3,644.71 / $5,481.35
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,465.60 / $3,377.87 / $5,133.82
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,463.17 / $4,541.39 / $12,292.49
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$279.11 / $597.00 / $23,612.00
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$202.20 / $2,936.21 / $9,036.94
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,444.00 / $6,762.00 / $16,403.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,304.32 / $3,746.08 / $8,117.66
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$217.78 / $217.78 / $353.34
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$517.49 / $3,377.87 / $5,133.82