go back

Louisiana 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
$443.74 / $1,520.00 / $3,685.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$335.81 / $443.74 / $609.52
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$606.59 / $606.59 / $606.59
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$797.63 / $4,212.17 / $9,391.41
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$361.89 / $503.11 / $640.51
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,958.75 / $5,958.75 / $5,958.75
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$638.89 / $638.89 / $638.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$308.08 / $458.07 / $676.45
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$341.00 / $1,049.00 / $2,271.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.04 / $521.97 / $769.37