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Missouri 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
Facility
Modifier
Low / Median / High Price
$404.49 / $613.38 / $33,533.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$404.49 / $613.38 / $794.88
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.67 / $599.96 / $1,074.66
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,305.35 / $2,413.89 / $3,038.89
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$404.49 / $915.10 / $4,532.39
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$583.19 / $716.29 / $4,140.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$583.19 / $714.38 / $1,212.50