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North Dakota 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
$79.19 / $79.19 / $130.77
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$155.55 / $177.89 / $254.65
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$67.59 / $77.90 / $101.65
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$344.55 / $425.19 / $445.13
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$149.26 / $184.19 / $192.53
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
$177.34 / $291.00 / $458.97
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$84.79 / $143.37 / $197.33
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$179.00 / $322.20 / $1,115.94
Medica
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$80.12 / $144.22 / $476.34
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$179.00 / $314.36 / $404.62
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$78.38 / $133.79 / $186.66