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Utah 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

Facilitymedian $3,020 · 10th–90th $182–$4,5710%20%10th90th$3,020Professionalmedian $141 · 10th–90th $95–$2690%10%10th90th$141$50.0$100.0$200.0$500.0$1.0K$2.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $3,019.95 / $4,570.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $134.90 / $269.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $169.82 / $251.19
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $239.88
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,949.84 / $2,691.53 / $4,073.80
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $181.97 / $234.42
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $194.98 / $316.23
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $194.98 / $269.15
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $4,466.84 / $5,128.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $151.36 / $251.19