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Oklahoma rates for HCPCS 55876

Plmt Interstitial Dev Radiat Tx Prostate 1/Mult

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$625.00 / $2,876.00 / $7,500.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.49 / $153.07 / $188.84
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,748.15 / $5,842.98 / $9,194.71
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.81 / $177.27 / $194.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.21 / $166.52 / $218.45
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$115.49 / $195.03 / $2,969.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$135.12 / $217.87 / $1,130.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$498.00 / $1,928.00 / $3,790.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$127.61 / $162.69 / $236.44