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New Hampshire 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 $661$1,4450%50%10th$1,445Professionalmedian $1,778 · 10th–90th $468$4,1690%5%10th90th$1,778$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
$1,445.44 / $1,445.44 / $1,445.44
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $2,238.72 / $4,677.35
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$302.00 / $512.86 / $1,047.13
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$1,122.02 / $1,778.28 / $3,630.78
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,786.30 / $4,786.30 / $4,786.30
Ambetter
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$338.84 / $575.44 / $1,380.38
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $2,570.40 / $3,715.35
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$416.87 / $588.84 / $851.14
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$1,548.82 / $1,949.84 / $2,884.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,137.96 / $2,884.03 / $5,623.41
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$501.19 / $588.84 / $1,258.93
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$1,659.59 / $2,344.23 / $4,365.16
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,290.87 / $3,890.45 / $6,025.60
Harvard Pilgrim
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$489.78 / $831.76 / $1,258.93
Harvard Pilgrim
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$1,778.28 / $3,019.95 / $4,677.35
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,041.74 / $2,630.27 / $6,025.60
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$436.52 / $562.34 / $1,288.25
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$1,698.24 / $2,041.74 / $4,786.30
Well Sense
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$316.23 / $316.23 / $316.23