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New Hampshire 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
$2,398.83 / $3,090.30 / $11,481.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $794.33 / $2,290.87
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,332.54 / $10,715.19 / $15,848.93
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $1,659.59 / $2,398.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.42 / $1,513.56 / $2,630.27
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,220.18 / $11,220.18 / $11,220.18
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $1,258.93 / $2,137.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,220.18 / $11,220.18 / $11,220.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.76 / $1,288.25 / $2,630.27