go back

Alaska rates for HCPCS 77331

Special dosimetry (eg, TLD, microdosimetry) (specify), only when prescribed by the treating physician

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$140.31 / $140.31 / $140.31
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.57 / $66.29 / $215.52
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$37.99 / $44.36 / $160.72
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$17.57 / $21.93 / $54.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$182.90 / $182.90 / $213.94
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$135.66 / $135.66 / $160.88
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$47.23 / $47.23 / $53.05
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.40 / $191.16 / $344.75
Moda Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$112.40 / $134.88 / $144.77
Moda Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$46.90 / $56.28 / $60.41
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$230.00 / $263.25 / $561.20
Premera BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$162.50 / $184.95 / $396.50
Premera BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$67.50 / $78.30 / $164.70
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.49 / $243.75 / $506.00
Providence
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$160.88 / $196.50 / $396.50
Providence
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$53.05 / $79.50 / $164.70
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.96 / $256.70 / $979.30
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$57.83 / $193.08 / $736.57
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$28.13 / $63.63 / $242.73