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Maine rates for HCPCS 55876

Plmt Interstitial Dev Radiat Tx Prostate 1/Mult

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$594.27 / $1,299.08 / $1,729.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$96.70 / $137.55 / $200.43
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$116.49 / $162.12 / $240.17
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$137.65 / $208.30 / $309.89
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$126.55 / $184.25 / $286.69
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$594.27 / $1,299.08 / $1,729.38
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.82 / $144.40 / $200.43
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.38 / $208.27 / $318.63