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Michigan 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 / $1,693.72 / $3,199.25
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$942.47 / $942.47 / $942.47
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,388.49 / $1,461.57 / $1,973.12
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,125.72 / $1,233.71 / $1,906.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,244.44 / $2,026.52 / $2,525.86
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,040.58 / $1,242.31 / $1,838.67
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$777.40 / $940.01 / $1,218.49
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,126.63 / $1,467.03 / $2,106.39