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Rhode Island rates for HCPCS 77295

3-D Radiotherapy Plan Dose-Volume Histograms

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$1,377.81 / $1,377.81 / $1,377.81
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.23 / $557.72 / $867.93
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$150.16 / $210.58 / $388.55
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$173.06 / $306.66 / $384.32
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$517.78 / $584.29 / $1,199.40
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$189.74 / $271.06 / $460.67
BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$219.28 / $313.25 / $639.05
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$608.65 / $996.87 / $1,354.15
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$282.35 / $461.02 / $618.95
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$326.30 / $535.85 / $735.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$498.04 / $810.86 / $1,366.60
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$200.34 / $334.90 / $383.39
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$265.62 / $445.60 / $935.69