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Utah rates for HCPCS 55876

Plmt Interstitial Dev Radiat Tx Prostate 1/Mult

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$135.02 / $2,871.00 / $4,387.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.82 / $135.02 / $202.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$126.16 / $173.29 / $249.70
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.96 / $141.81 / $183.27
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,089.01 / $2,638.66 / $3,828.61
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.26 / $178.67 / $219.99
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,689.00 / $2,312.00 / $4,640.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$137.28 / $155.19 / $308.64