go back

West Virginia 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
$76.81 / $76.81 / $76.81
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$233.65 / $237.69 / $308.17
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$109.64 / $109.64 / $109.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$254.75 / $396.16 / $1,526.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$184.76 / $260.33 / $478.34