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Montana rates for HCPCS 77316

Brachytherapy isodose plan; simple (calculation[s] made from 1 to 4 sources, or remote afterloading brachytherapy, 1 channel), includes basic dosimetry calculation(s)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$196.42 / $762.40 / $1,267.16
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$388.57 / $388.57 / $388.57
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$115.15 / $115.15 / $142.35
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.11 / $248.67 / $388.57
Providence
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$115.15 / $115.15 / $142.35
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$230.01 / $303.80 / $448.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$240.60 / $278.33 / $391.05