go back

Maine rates for HCPCS 77331

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.48 / $66.07 / $147.91
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$38.02 / $47.86 / $104.71
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$15.14 / $19.95 / $43.65
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.66 / $91.20 / $104.71
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$43.65 / $64.57 / $74.13
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$18.20 / $26.92 / $31.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.62 / $120.23 / $158.49
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$54.95 / $83.18 / $112.20
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$22.91 / $34.67 / $45.71
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.28 / $95.50 / $186.21
Harvard Pilgrim
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$57.54 / $67.61 / $131.83
Harvard Pilgrim
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$23.99 / $28.18 / $54.95
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.95 / $77.62 / $204.17
Martin's Point
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$38.02 / $53.70 / $134.90
Martin's Point
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$17.38 / $24.55 / $66.07
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.10 / $89.13 / $169.82
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$45.71 / $63.10 / $117.49
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$17.38 / $25.70 / $47.86