go back

Massachusetts 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
$23.51 / $23.52 / $89.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.71 / $75.56 / $831.18
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$27.07 / $221.76 / $776.16
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$25.19 / $39.58 / $75.08
AllWays Health Partners
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$36.40 / $77.43 / $170.00
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.55 / $101.91 / $468.11
AllWays Health Partners
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$28.23 / $43.74 / $378.10
AllWays Health Partners
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$30.42 / $59.98 / $378.10
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.40 / $137.74 / $182.05
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$52.41 / $65.67 / $85.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.19 / $134.53 / $219.26
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$36.78 / $62.10 / $103.88
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$42.17 / $74.05 / $115.38
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.47 / $59.46 / $108.96
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.74 / $155.13 / $248.32
Harvard Pilgrim
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$40.54 / $76.03 / $103.40
Harvard Pilgrim
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$42.19 / $79.11 / $107.54
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$94.48 / $201.25 / $1,006.26
Mass General Brigham
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$76.59 / $170.00 / $170.00
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.64 / $111.98 / $468.11
Mass General Brigham
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$31.34 / $48.79 / $378.10
Mass General Brigham
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$40.22 / $66.01 / $378.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.56 / $102.40 / $180.97
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$31.34 / $43.74 / $87.71
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$37.17 / $59.98 / $119.35