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Idaho rates for HCPCS 55876

Plmt Interstitial Dev Radiat Tx Prostate 1/Mult

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$303.68 / $1,891.12 / $7,045.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.03 / $160.90 / $301.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.07 / $192.79 / $254.72
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$132.66 / $211.30 / $301.64
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$163.85 / $198.60 / $289.18
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $207.67 / $261.26
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,448.63 / $3,500.16 / $4,198.27
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$156.01 / $190.78 / $284.01
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,450.00 / $6,124.00 / $7,609.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$146.68 / $194.42 / $286.37