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Arizona rates for HCPCS 55876

Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), prostate (via needle, any approach), single or multiple

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$936.00 / $2,508.00 / $5,506.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.03 / $146.43 / $387.94
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$438.60 / $1,640.88 / $2,700.74
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.13 / $110.59 / $155.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,772.42 / $1,772.42 / $1,772.42
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.65 / $152.61 / $258.55
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$107.31 / $166.79 / $2,086.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.58 / $181.89 / $1,130.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,578.00 / $2,567.00 / $5,029.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.96 / $154.80 / $289.02