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Utah rates for HCPCS 61797

Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); each additional cranial lesion, simple (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$316.23 / $316.23 / $316.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $239.88 / $2,137.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.88 / $309.03 / $478.63
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $676.08
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$346.74 / $512.86 / $1,348.96
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.98 / $512.86 / $691.83
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$316.23 / $380.19 / $524.81
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,698.24 / $4,466.84 / $5,128.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.53 / $263.03 / $457.09