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Pennsylvania rates for HCPCS 77301

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

Facilitymedian $912 · 10th–90th $389$1,6220%10%10th90th$912Professionalmedian $1,259 · 10th–90th $398$3,9810%5%10%10th90th$1,259$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
$407.38 / $912.01 / $1,621.81
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,584.89 / $2,344.23 / $10,232.93
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$371.54 / $616.60 / $1,737.80
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$1,202.26 / $1,737.80 / $5,623.41
Ambetter
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$407.38 / $416.87 / $812.83
AmeriHealth
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$426.58 / $436.52 / $562.34
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $2,344.23 / $3,467.37
Capital Blue Cross
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$426.58 / $524.81 / $933.25
Capital Blue Cross
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$1,348.96 / $1,778.28 / $2,754.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $2,187.76 / $3,548.13
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$354.81 / $489.78 / $794.33
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$1,096.48 / $1,737.80 / $2,754.23
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,511.89 / $2,511.89 / $3,388.44
Emblem Health
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$549.54 / $549.54 / $691.83
Emblem Health
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$1,995.26 / $1,995.26 / $2,691.53
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $2,290.87 / $3,630.78
Geisinger
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$323.59 / $501.19 / $831.76
Geisinger
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$812.83 / $1,778.28 / $2,818.38
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $2,238.72 / $2,691.53
Highmark BCBS
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$426.58 / $478.63 / $707.95
Independence Blue Cross
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$426.58 / $436.52 / $562.34
Martin's Point
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$371.54 / $616.60 / $1,348.96
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,584.89 / $2,344.23 / $4,365.16
Martin's Point
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$354.81 / $501.19 / $912.01
Martin's Point
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$1,202.26 / $1,905.46 / $3,311.31
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $3,548.13 / $4,073.80
UPMC Health Plan
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$407.38 / $416.87 / $446.68
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $1,380.38 / $1,905.46
UPMC Health Plan
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$407.38 / $416.87 / $446.68
UPMC Health Plan
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$954.99 / $1,348.96 / $1,479.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $2,137.96 / $3,548.13
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$354.81 / $478.63 / $794.33
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$1,202.26 / $1,698.24 / $2,818.38