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Idaho 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
$457.09 / $1,905.46 / $5,495.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.71 / $158.49 / $302.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$338.84 / $1,949.84 / $3,630.78
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $239.88 / $295.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.23 / $181.97 / $257.04
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$131.83 / $245.47 / $1,905.46
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.82 / $181.97 / $302.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $33.11
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,511.89 / $3,090.30 / $4,365.16
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.04 / $194.98 / $245.47
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.25 / $186.21 / $3,019.95
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,467.37 / $6,165.95 / $7,762.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.65 / $169.82 / $257.04