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Utah rates for HCPCS 77295

3-Dimensional Radiotherapy Plan, Including Dose-Volume Histograms

Facilitymedian $251 · 10th–90th $251–$2510%50%$251Professionalmedian $468 · 10th–90th $219–$1,3490%10%10th90th$468$50.0$100.0$200.0$500.0$1.0K$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$251.19 / $251.19 / $251.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $616.60 / $2,089.30
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$213.80 / $407.38 / $588.84
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$218.78 / $338.84 / $1,148.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $724.44 / $1,023.29
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$269.15 / $316.23 / $416.87
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$295.12 / $380.19 / $537.03
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $60.26 / $891.25
Regence BlueShield
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$2,290.87 / $2,290.87 / $2,290.87
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $831.76 / $977.24
Regence BlueShield
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$331.13 / $389.05 / $467.74
Regence BlueShield
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$380.19 / $446.68 / $512.86
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $870.96 / $1,122.02
Select Health
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$223.87 / $416.87 / $501.19
Select Health
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$263.03 / $457.09 / $549.54
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $407.38 / $912.01
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $707.95 / $3,019.95
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$263.03 / $288.40 / $467.74
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$309.03 / $346.74 / $524.81