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New Hampshire 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

Facilitymedian $112 · 10th–90th $51$1120%50%10th$112Professionalmedian $66 · 10th–90th $31$1410%5%10%10th90th$66$20.0$50.0$100.0$200.0$500.0$1.0K

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$112.20 / $112.20 / $112.20
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $75.86 / $165.96
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$22.91 / $38.90 / $151.36
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$25.12 / $39.81 / $83.18
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $162.18 / $162.18
Ambetter
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$26.30 / $46.77 / $109.65
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $93.33 / $134.90
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$32.36 / $45.71 / $66.07
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$34.67 / $47.86 / $69.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $107.15 / $199.53
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$38.90 / $45.71 / $97.72
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$44.67 / $67.61 / $104.71
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $128.82 / $208.93
Harvard Pilgrim
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$38.02 / $64.57 / $97.72
Harvard Pilgrim
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$39.81 / $67.61 / $107.15
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $95.50 / $245.47
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$33.88 / $43.65 / $100.00
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$39.81 / $51.29 / $107.15
Well Sense
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$24.55 / $24.55 / $24.55