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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
$1,000.00 / $1,258.93 / $6,918.31
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,584.89 / $1,584.89 / $1,584.89
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,698.24 / $1,905.46 / $4,570.88
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.24 / $1,621.81 / $2,238.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,548.82 / $1,737.80 / $2,511.89