go back

Iowa rates for HCPCS 77295

3-D Radiotherapy Plan Dose-Volume Histograms

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$210.68 / $638.57 / $1,070.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$449.31 / $697.15 / $2,751.00
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$216.01 / $469.88 / $1,230.00
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$233.30 / $381.89 / $1,800.47
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$716.70 / $738.20 / $759.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$946.20 / $1,137.95 / $1,422.44
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$451.66 / $523.60 / $654.50
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$494.54 / $614.35 / $767.94
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$431.24 / $795.33 / $3,161.78
Hally Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$210.45 / $342.90 / $1,164.03
Hally Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$220.78 / $414.00 / $1,842.60
Medica
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$738.20 / $738.20 / $738.20
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$508.71 / $912.51 / $4,584.85
Medica
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$244.85 / $297.58 / $1,699.00
Medica
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$263.86 / $359.80 / $6,233.93
Midlands
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$738.20 / $759.70 / $1,255.32
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$905.62 / $1,079.82 / $1,947.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$227.96 / $423.35 / $806.12
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$508.71 / $616.87 / $1,001.96
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$244.85 / $289.86 / $429.60
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$263.86 / $340.11 / $1,193.04
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$710.29 / $899.10 / $1,057.80
Wellmark
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$331.56 / $419.70 / $493.70
Wellmark
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$378.73 / $479.40 / $564.10