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Utah 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
$79.43 / $79.43 / $79.43
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.96 / $251.19 / $1,000.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.42 / $263.03 / $446.68
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $56.23 / $338.84
Regence BlueShield
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$616.60 / $616.60 / $616.60
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$346.74 / $371.54 / $407.38
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$229.09 / $398.11 / $467.74
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.20 / $275.42 / $436.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $275.42 / $436.52