| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
BCBS
| Facility | $252.96 | $385.16 | $842.44 | |
Hally Health
| Professional | $100.00 | $150.00 | $345.40 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 |
Teletherapy, isodose plan (whether hand or computer calculated); complex (mantle or inverted Y, tangential ports, the use of wedges, compensators, complex blocking, rotational beam, or special beam considerations) (Only 1 teletherapy isodose plan may be reported for a given course of therapy to a specific treatment area)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
BCBS
| Facility | $252.96 | $385.16 | $842.44 | |
Hally Health
| Professional | $100.00 | $150.00 | $345.40 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 |