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Montana 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
Professional
Modifier
Low / Median / High Price
$220.00 / $233.65 / $550.72
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$511.08 / $511.08 / $511.08
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$150.90 / $150.90 / $186.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.75 / $324.94 / $511.08
Providence
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$150.90 / $150.90 / $186.55
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$304.08 / $397.51 / $590.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$310.60 / $364.95 / $512.73