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Arizona rates for HCPCS 77301

Intensity modulated radiotherapy plan, including dose-volume histograms for target and critical structure partial tolerance specifications

Facilitymedian $1,445 · 10th–90th $646–$1,9950%10%20%10th90th$1,445Professionalmedian $1,445 · 10th–90th $407–$4,1690%5%10th90th$1,445$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

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
$645.65 / $1,445.44 / $1,995.26
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,380.38 / $2,398.83 / $9,772.37
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$346.74 / $588.84 / $1,949.84
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$1,122.02 / $1,905.46 / $4,677.35
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $1,995.26 / $13,803.84
BCBS
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$436.52 / $446.68 / $3,162.28
BCBS
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$1,479.11 / $1,513.56 / $10,715.19
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $2,344.23 / $3,630.78
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$363.08 / $489.78 / $741.31
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$1,318.26 / $1,862.09 / $2,951.21
Medica
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$977.24 / $1,905.46 / $1,905.46
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $2,511.89 / $13,489.63
Medica
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$446.68 / $537.03 / $2,818.38
Medica
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$1,737.80 / $2,041.74 / $8,912.51
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $2,454.71 / $3,548.13
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$436.52 / $524.81 / $724.44
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$1,548.82 / $1,949.84 / $2,951.21