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South Carolina 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
$269.15 / $4,897.79 / $13,489.63
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.18 / $2,884.03 / $6,309.57
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.15 / $177.83 / $251.19
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,258.93 / $5,248.07 / $12,302.69
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.54 / $251.19 / $4,365.16
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,011.87 / $5,011.87 / $6,456.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.53 / $436.52 / $6,025.60
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$173.78 / $2,884.03 / $6,606.93
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $33.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,709.64 / $20,417.38 / $25,703.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.18 / $2,187.76 / $6,025.60