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Utah 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 $34 · 10th–90th $34$340%50%$34Professionalmedian $145 · 10th–90th $37$7590%5%10th90th$145$20.0$100.0$500.0$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
$33.88 / $33.88 / $33.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $316.23 / $1,548.82
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$34.67 / $169.82 / $707.95
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$28.18 / $40.74 / $933.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $91.20 / $120.23
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$38.90 / $42.66 / $56.23
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$38.90 / $48.98 / $61.66
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $120.23
Regence BlueShield
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$229.09 / $229.09 / $229.09
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $114.82 / $131.83
Regence BlueShield
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$47.86 / $56.23 / $67.61
Regence BlueShield
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$50.12 / $58.88 / $67.61
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $120.23 / $141.25
Select Health
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$32.36 / $60.26 / $72.44
Select Health
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$34.67 / $60.26 / $70.79
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $57.54 / $112.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $87.10 / $134.90
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$35.48 / $41.69 / $95.50
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$40.74 / $46.77 / $95.50