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Oklahoma 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
$750.00 / $3,592.07 / $7,500.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$168.55 / $2,911.75 / $3,592.07
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,198.18 / $19,015.74 / $29,923.83
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$198.72 / $3,472.95 / $3,972.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$192.86 / $256.14 / $3,982.77
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$168.55 / $3,057.34 / $10,701.05
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,828.74 / $4,745.99 / $20,949.68
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,570.00 / $6,980.00 / $13,541.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,645.62 / $3,910.39 / $5,590.44