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South Dakota rates for HCPCS 77301

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

Facilitymedian $427 · 10th–90th $427$4270%50%100%$427Professionalmedian $1,202 · 10th–90th $407$3,3880%10%20%10th90th$1,202$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$426.58 / $426.58 / $426.58
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $2,041.74 / $3,311.31
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$371.54 / $426.58 / $1,202.26
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$1,288.25 / $1,621.81 / $2,754.23
Avera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,398.83 / $2,398.83 / $2,398.83
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,073.80 / $4,466.84 / $5,623.41
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$912.01 / $1,000.00 / $1,258.93
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$3,162.28 / $3,467.37 / $4,365.16
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $2,570.40 / $4,365.16
Medica
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$398.11 / $776.25 / $2,187.76
Medica
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$1,288.25 / $2,041.74 / $4,466.84
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,365.16 / $4,365.16 / $4,365.16
Midlands
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$977.24 / $977.24 / $977.24
Midlands
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$3,388.44 / $3,388.44 / $3,388.44
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,398.83 / $3,162.28 / $3,630.78
Sanford Health Plan
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$501.19 / $691.83 / $812.83
Sanford Health Plan
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$1,862.09 / $2,511.89 / $2,754.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $3,235.94 / $5,248.07
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$398.11 / $776.25 / $1,174.90
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$1,698.24 / $2,344.23 / $4,073.80
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,388.44 / $4,073.80 / $4,073.80
Wellmark
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$776.25 / $912.01 / $912.01
Wellmark
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$2,630.27 / $3,090.30 / $3,090.30