go back

Illinois rates for HCPCS 77295

3-D Radiotherapy Plan Dose-Volume Histograms

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$208.43 / $317.68 / $638.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$407.23 / $557.72 / $1,550.46
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$198.28 / $292.75 / $760.27
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$209.55 / $347.18 / $693.98
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$376.17 / $488.29 / $508.94
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$164.59 / $240.03 / $274.32
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$286.08 / $570.05 / $1,092.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$490.43 / $732.44 / $1,517.26
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$217.81 / $308.61 / $484.38
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$253.63 / $392.96 / $1,198.43
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$490.89 / $825.58 / $4,354.43
Hally Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$245.33 / $365.76 / $2,273.08
Hally Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$272.69 / $439.24 / $2,886.97
Hally Health
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$580.14 / $588.58 / $634.78
Hally Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$277.33 / $280.39 / $297.18
Hally Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$299.74 / $311.25 / $337.61
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $301.97 / $664.07
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$498.04 / $697.26 / $1,334.44
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$229.42 / $294.07 / $462.72
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$269.39 / $389.68 / $779.32