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Iowa rates for HCPCS 57155

Insertion of uterine tandem and/or vaginal ovoids for clinical brachytherapy

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,906.00 / $4,235.59 / $7,119.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.61 / $383.22 / $1,495.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.75 / $817.08 / $1,165.73
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$266.43 / $570.55 / $1,063.43
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$538.51 / $896.23 / $5,847.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$506.07 / $868.62 / $4,954.00
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$629.54 / $932.81 / $4,164.35
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$560.60 / $755.28 / $1,066.48
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$262.87 / $525.29 / $4,465.74
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,775.00 / $3,522.00 / $5,454.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$440.11 / $756.41 / $1,193.91
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$545.29 / $641.60 / $901.20