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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
$234.42 / $302.00 / $1,000.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.05 / $389.05 / $389.05
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$114.82 / $114.82 / $141.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.98 / $251.19 / $389.05
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$295.12 / $426.58 / $794.33
Providence
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$114.82 / $114.82 / $141.25
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$229.09 / $346.74 / $575.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.88 / $275.42 / $380.19