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Montana 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 / $1,693.72 / $7,105.75
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,569.51 / $1,569.51 / $1,569.51
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$972.12 / $1,192.14 / $1,849.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,538.33 / $1,739.11 / $2,161.26