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Washington rates for HCPCS 57155

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

Facilitymedian $871 · 10th–90th $468–$13,8040%10%10th90th$871Professionalmedian $490 · 10th–90th $257–$1,0000%10%20%10th90th$490$20.0$100.0$500.0$2.0K$10.0K$50.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$467.74 / $1,148.15 / $13,803.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $380.19 / $933.25
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,754.40 / $13,182.57 / $26,915.35
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $645.65 / $933.25
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,162.28 / $3,162.28 / $5,248.07
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $691.83 / $1,122.02
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$416.87 / $724.44 / $4,466.84
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $691.83 / $1,258.93
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $75.86
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $776.25 / $794.33
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $524.81 / $549.54
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $616.60 / $1,000.00
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,120.11 / $13,803.84 / $26,915.35
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $645.65 / $912.01
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,096.48 / $15,488.17 / $28,840.32
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $562.34 / $977.24
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $446.68 / $575.44