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Hawaii rates for HCPCS 0395T

High dose rate electronic brachytherapy, interstitial or intracavitary treatment, per fraction, includes basic dosimetry, when performed

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $707.95 / $776.25
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.93 / $602.56 / $741.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.58 / $758.58 / $1,047.13