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North Dakota rates for HCPCS 77295

3-D Radiotherapy Plan Dose-Volume Histograms

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$229.63 / $229.63 / $391.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$472.91 / $504.95 / $1,051.97
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$198.28 / $229.63 / $1,022.40
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$244.94 / $306.66 / $381.89
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$938.67 / $1,011.70 / $1,195.33
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$438.13 / $470.07 / $555.39
BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$500.54 / $541.63 / $639.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$652.76 / $930.63 / $1,445.01
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$266.95 / $428.20 / $535.60
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$361.52 / $502.43 / $1,025.25
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$545.41 / $988.26 / $7,381.05
Medica
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$232.42 / $445.62 / $1,699.00
Medica
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$300.32 / $546.04 / $6,233.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$498.04 / $931.04 / $1,240.99
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$232.42 / $401.06 / $573.58
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$265.62 / $491.43 / $667.41