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Virginia rates for HCPCS 55876

Plmt Interstitial Dev Radiat Tx Prostate 1/Mult

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$158.71 / $1,346.00 / $6,927.27
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.03 / $158.71 / $259.27
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,060.00 / $3,693.00 / $4,290.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.45 / $145.02 / $217.23
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$118.74 / $175.52 / $3,026.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.67 / $170.24 / $278.68
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$142.02 / $170.42 / $210.19
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$114.15 / $172.36 / $257.87
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.00 / $201.60 / $282.00
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$106.43 / $138.65 / $2,039.00
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$148.76 / $188.72 / $2,039.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,911.00 / $3,276.00 / $5,340.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.67 / $196.93 / $318.37