go back

Ohio rates for HCPCS 77301

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

Facilitymedian $513 · 10th–90th $389$7240%20%10th90th$513Professionalmedian $1,445 · 10th–90th $407$3,0900%10%10th90th$1,445$5.0$20.0$100.0$500.0$2.0K$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
$389.05 / $512.86 / $724.44
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,621.81 / $2,344.23 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$380.19 / $616.60 / $1,148.15
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$1,258.93 / $1,995.26 / $3,890.45
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,548.82 / $1,862.09
Ambetter
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$323.59 / $416.87 / $616.60
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $2,041.74 / $3,019.95
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$416.87 / $549.54 / $794.33
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$1,148.15 / $1,479.11 / $2,187.76
Aultcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $2,511.89 / $3,630.78
Aultcare
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$467.74 / $575.44 / $812.83
Aultcare
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$1,479.11 / $1,949.84 / $2,818.38
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $1,584.89 / $2,884.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $2,454.71 / $4,466.84
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$398.11 / $549.54 / $1,000.00
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$1,258.93 / $1,862.09 / $3,467.37
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,584.89 / $2,238.72 / $3,715.35
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$398.11 / $549.54 / $977.24
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$1,288.25 / $1,778.28 / $3,019.95
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $33.11
SummaCare
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$1,698.24 / $1,698.24 / $1,698.24
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,238.72 / $4,073.80
SummaCare
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$446.68 / $524.81 / $812.83
SummaCare
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$1,479.11 / $1,737.80 / $3,235.94
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,348.96 / $2,137.96 / $3,311.31
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$302.00 / $457.09 / $776.25
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$1,071.52 / $1,659.59 / $2,630.27