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Pennsylvania 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
$147.91 / $2,290.87 / $7,244.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.20 / $144.54 / $380.19
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.71 / $141.25 / $165.96
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.82 / $177.83 / $257.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.65 / $158.49 / $269.15
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.97 / $234.42 / $257.04
Geisinger
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.23 / $190.55 / $269.15
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$676.08 / $831.76 / $5,128.61
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$218.78 / $1,995.26 / $6,165.95
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.72 / $158.49 / $389.05
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$204.17 / $204.17 / $316.23
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.78 / $239.88 / $302.00
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.72 / $147.91 / $257.04
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.62 / $147.91 / $309.03
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$912.01 / $2,570.40 / $5,011.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $144.54 / $245.47