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Missouri rates for HCPCS 77295

3-Dimensional Radiotherapy Plan, Including Dose-Volume Histograms

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$218.59 / $270.14 / $500.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$391.64 / $521.16 / $2,825.37
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$197.68 / $251.67 / $897.75
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$205.75 / $306.66 / $1,392.30
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$350.22 / $350.22 / $532.30
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$173.28 / $284.18 / $341.97
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$455.82 / $568.35 / $1,347.59
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$221.08 / $271.95 / $455.37
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$234.74 / $297.31 / $890.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$433.42 / $708.91 / $1,451.63
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$214.28 / $320.19 / $484.38
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$244.74 / $379.49 / $1,031.03
Medica
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$528.44 / $1,325.34 / $1,325.34
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$488.91 / $717.47 / $7,381.05
Medica
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$228.14 / $280.82 / $1,699.00
Medica
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$257.13 / $376.74 / $6,233.93
Qualchoice
Facility/Professional
Professional
Modifier
Low / Median / High Price
$840.83 / $840.83 / $840.83
Qualchoice
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$411.80 / $411.80 / $411.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$484.16 / $630.45 / $1,300.38
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$215.04 / $269.26 / $477.16
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$239.73 / $342.28 / $838.19