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Nebraska 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
$599.16 / $599.16 / $599.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$599.16 / $599.16 / $599.16
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$974.78 / $1,282.09 / $2,479.98
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,092.06 / $1,167.30 / $1,196.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,100.83 / $1,197.68 / $1,488.38
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$539.25 / $1,138.42 / $4,532.39
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$695.18 / $1,098.06 / $4,140.28
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$613.66 / $1,092.71 / $1,436.42
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$905.45 / $1,143.25 / $1,561.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$695.18 / $1,098.06 / $1,407.78