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Missouri 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
$559.65 / $3,909.61 / $13,177.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$216.87 / $303.14 / $1,215.80
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$342.61 / $405.47 / $454.12
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,224.00 / $4,500.00 / $13,226.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$279.82 / $430.23 / $693.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$277.58 / $520.46 / $832.02
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$274.88 / $551.60 / $16,394.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$393.59 / $604.72 / $4,954.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$899.00 / $1,770.00 / $17,638.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.04 / $515.96 / $1,009.84