go back

Delaware rates for HCPCS 77317

Brachytherapy isodose plan; intermediate (calculation[s] made from 5 to 10 sources, or remote afterloading brachytherapy, 2-12 channels), includes basic dosimetry calculation(s)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$108.42 / $127.28 / $127.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$259.60 / $275.06 / $294.49
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$259.20 / $294.10 / $388.79
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$241.77 / $329.56 / $642.65