go back

Pennsylvania 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
$71.25 / $109.26 / $248.66
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$185.49 / $219.55 / $1,001.00
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.97 / $311.68 / $383.11
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$83.69 / $83.69 / $83.69
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.85 / $247.13 / $420.25
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$237.34 / $310.58 / $385.55
Martin's Point
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$71.25 / $130.38 / $281.44
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$189.49 / $270.56 / $1,001.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.26 / $270.54 / $464.56
Priority Health
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$83.69 / $83.69 / $83.69
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$184.65 / $251.10 / $420.25
UPMC Health Plan
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$72.36 / $72.36 / $77.84
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.84 / $233.89 / $253.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$180.12 / $244.94 / $411.98