go back

Missouri rates for HCPCS 76873

Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$66.59 / $103.85 / $170.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$148.86 / $171.34 / $473.87
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$66.59 / $75.20 / $445.44
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$130.82 / $130.82 / $130.82
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$160.69 / $196.36 / $318.07
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$76.98 / $94.69 / $146.60
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$86.87 / $86.87 / $86.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.69 / $211.17 / $378.54
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$64.86 / $100.02 / $179.37
Medica
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$179.26 / $343.65 / $343.65
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.97 / $215.51 / $1,115.94
Medica
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$73.91 / $96.14 / $476.34
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$160.43 / $190.20 / $324.43
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$72.04 / $88.13 / $145.77