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Nebraska 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
$1,653.00 / $5,463.36 / $13,841.56
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$266.70 / $372.83 / $786.67
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,779.83 / $8,379.12 / $14,704.82
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$281.00 / $515.70 / $761.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$517.23 / $847.43 / $1,096.32
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$335.55 / $633.80 / $1,775.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$534.63 / $884.98 / $4,954.00
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$629.54 / $884.27 / $3,843.59
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$560.60 / $757.83 / $1,036.38
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.00 / $595.40 / $1,016.80
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,775.00 / $3,227.00 / $6,169.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$481.68 / $850.39 / $963.02