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New Hampshire 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
Facility
Modifier
26
Low / Median / High Price
$112.36 / $112.36 / $112.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$145.60 / $190.09 / $349.76
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$240.66 / $341.79 / $495.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$310.98 / $504.97 / $754.05
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$275.61 / $524.88 / $980.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.92 / $333.05 / $975.28
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$161.27 / $201.59 / $308.58