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New Mexico 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
$390.52 / $5,000.27 / $7,838.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.46 / $348.38 / $478.45
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$991.66 / $2,363.84 / $3,677.63
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$254.50 / $439.55 / $671.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$250.12 / $476.96 / $741.69
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $112.58 / $613.34
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$406.68 / $556.72 / $627.41
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$250.12 / $476.75 / $719.55
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,824.00 / $2,516.00 / $2,655.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$490.51 / $630.42 / $948.31