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Utah rates for HCPCS 55874

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

Facilitymedian $3,981 · 10th–90th $2,630–$9,5500%10%20%10th90th$3,981Professionalmedian $2,818 · 10th–90th $158–$6,6070%10%10th90th$2,818$50.0$200.0$1.0K$5.0K$20.0K

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
$2,630.27 / $3,981.07 / $9,549.93
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $2,754.23 / $6,606.93
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $489.78 / $5,128.61
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $15,848.93
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,244.36 / $10,000.00 / $15,135.61
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $316.23 / $6,456.54
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $3,019.95 / $7,079.46
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $3,548.13 / $12,022.64
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,698.24 / $5,128.61 / $15,848.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $2,511.89 / $6,025.60