go back

Idaho rates for HCPCS 55875

Transperineal placement of needles or catheters into prostate for interstitial radioelement application, with or without cystoscopy

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,318.26 / $2,884.03 / $5,495.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $1,023.29 / $1,548.82
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,570.40 / $5,623.41 / $13,489.63
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,318.26 / $1,548.82 / $1,584.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$912.01 / $1,230.27 / $1,479.11
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$933.25 / $1,548.82 / $5,495.41
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $1,202.26 / $1,548.82
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $33.11
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,511.38 / $11,748.98 / $16,218.10
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $1,258.93 / $1,513.56
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.65 / $1,348.96 / $12,302.69
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,232.93 / $25,118.86 / $38,904.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $1,071.52 / $1,584.89