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Louisiana 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
$762.00 / $1,869.00 / $4,392.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$726.46 / $1,078.85 / $1,331.88
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,084.36 / $7,716.36 / $10,896.84
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,001.38 / $1,134.89 / $1,389.40
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,350.33 / $5,350.33 / $5,350.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$744.41 / $995.03 / $1,335.04
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,149.00 / $5,348.00 / $11,580.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$686.12 / $981.33 / $1,608.48