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Montana rates for HCPCS 0395T

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

Facilitymedian $1,122 · 10th–90th $1,096–$2,1880%20%10th90th$1,122Professionalmedian $708 · 10th–90th $457–$1,0960%20%40%10th90th$708$200.0$500.0$1.0K$2.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $660.69 / $776.25
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,000.00 / $1,202.26
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,000.00 / $1,000.00
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,122.02 / $2,187.76
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,122.02 / $2,187.76
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $602.56 / $1,202.26
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,000.00 / $1,000.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $707.95 / $707.95
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $812.83 / $1,122.02