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Texas rates for HCPCS 77315

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
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$305.82 / $778.41 / $778.41
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,012.00 / $1,012.00 / $1,012.00
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$165.53 / $220.60 / $308.75
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$165.53 / $220.68 / $310.55
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$149.66 / $149.66 / $149.66