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Missouri 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
$1,092.27 / $6,851.00 / $7,105.75
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$685.55 / $1,020.64 / $1,407.31
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,139.57 / $1,494.17 / $2,519.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,505.75 / $2,309.69 / $4,947.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,064.54 / $1,666.61 / $8,883.41
Qualchoice
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,618.41 / $1,618.41 / $1,618.41
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,046.06 / $1,557.51 / $2,602.11