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Wisconsin 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 $83 · 10th–90th $49$1410%10%20%10th90th$83Professionalmedian $110 · 10th–90th $33$8510%5%10th90th$110$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$48.98 / $69.18 / $83.18
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $97.72 / $1,047.13
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$33.88 / $223.87 / $1,000.00
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$25.12 / $43.65 / $120.23
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $97.72 / $363.08
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$31.62 / $48.98 / $177.83
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$31.62 / $48.98 / $181.97
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $42.66 / $85.11
Cigna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$87.10 / $100.00 / $162.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $181.97 / $338.84
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$38.02 / $87.10 / $169.82
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$46.77 / $93.33 / $173.78
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $158.49 / $190.55
DeanCare
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$66.07 / $77.62 / $93.33
DeanCare
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$67.61 / $85.11 / $95.50
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $147.91 / $467.74
Medica
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$35.48 / $74.13 / $380.19
Medica
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$38.90 / $81.28 / $380.19
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $91.20
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $173.78 / $295.12
Network Health
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$45.71 / $81.28 / $147.91
Network Health
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$46.77 / $89.13 / $147.91
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $190.55 / $316.23
Quartz
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$100.00 / $204.17 / $204.17
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $323.59 / $467.74
Quartz
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$53.70 / $162.18 / $380.19
Quartz
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$58.88 / $169.82 / $380.19
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $213.80
Security Health
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$109.65 / $109.65 / $109.65
Security Health
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$107.15 / $107.15 / $107.15
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $407.38 / $501.19
Security Health
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$107.15 / $109.65 / $186.21
Security Health
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$107.15 / $112.20 / $199.53
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $190.55 / $489.78
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$38.90 / $93.33 / $208.93
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$40.74 / $95.50 / $204.17