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Delaware rates for HCPCS 77300

Basic radiation dosimetry calculation, central axis depth dose calculation, TDF, NSD, gap calculation, off axis factor, tissue inhomogeneity factors, calculation of non-ionizing radiation surface and depth dose, as required during course of treatment, only when prescribed by the treating physician

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$29.51 / $43.29 / $75.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.36 / $62.40 / $668.00
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$27.07 / $28.61 / $33.35
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$27.75 / $35.34 / $35.34
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.81 / $79.20 / $111.35
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$25.98 / $36.22 / $50.30
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$28.00 / $48.03 / $61.05
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$142.16 / $142.16 / $142.16
Highmark BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$33.42 / $43.24 / $61.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.34 / $92.38 / $151.66
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$26.02 / $34.86 / $73.39
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$29.32 / $58.65 / $75.73