go back

Georgia 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
$27.48 / $46.42 / $138.19
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.05 / $75.63 / $661.90
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$27.48 / $94.17 / $684.00
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$24.57 / $38.82 / $90.18
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.46 / $68.64 / $90.53
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$30.89 / $51.93 / $59.62
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.88 / $88.54 / $184.24
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$28.89 / $40.14 / $83.02
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$31.56 / $46.56 / $94.08
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.11 / $64.30 / $138.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.56 / $121.13 / $200.00
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$30.73 / $55.00 / $88.46
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$34.33 / $60.21 / $104.10
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.91 / $114.63 / $225.19
Kaiser Permanente
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$35.32 / $56.31 / $82.89
Kaiser Permanente
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$36.59 / $58.32 / $225.19
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.92 / $58.81 / $120.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.31 / $88.09 / $174.15
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$30.19 / $40.25 / $74.45
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$32.04 / $48.80 / $84.73