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Hawaii rates for HCPCS 77373

Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance, entire course not to exceed 5 fractions

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,129.15 / $1,838.67 / $8,357.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,245.83 / $1,465.68 / $1,465.68
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,040.13 / $2,554.46 / $3,100.63
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,118.26 / $1,302.83 / $1,519.97
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,465.68 / $2,106.66 / $2,108.75
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,407.72 / $2,064.53 / $3,517.70