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Indiana 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
$891.25 / $4,897.79 / $11,220.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$741.31 / $870.96 / $1,659.59
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,413.10 / $18,197.01 / $27,542.29
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $933.25 / $1,445.44
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$758.58 / $794.33 / $891.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,388.44 / $3,388.44 / $3,388.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$724.44 / $954.99 / $1,584.89
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,265.80 / $10,000.00 / $35,481.34
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $891.25 / $1,412.54