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 |
|---|---|---|---|---|---|
Cigna
| Professional | $239.16 | $292.44 | $365.55 | |
Medica
| Facility | $303.70 | $303.70 | $475.08 | |
Midlands
| Professional | $145.38 | $272.99 | $329.00 | |
Sanford Health Plan
| Professional | $147.02 | $212.02 | $214.65 |