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Maine 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
$1,693.72 / $1,790.81 / $1,838.67
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,073.27 / $1,348.34 / $1,898.03
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,209.81 / $1,399.75 / $2,626.26
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,194.94 / $1,790.81 / $3,587.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,209.81 / $1,947.11 / $3,064.64