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Ohio 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
$1,194.94 / $2,382.58 / $8,078.00
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$727.39 / $727.39 / $995.05
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,257.49 / $1,747.42 / $3,057.98
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$865.94 / $1,125.72 / $1,906.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,465.68 / $1,999.86 / $3,224.73
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,204.69 / $2,818.22 / $2,818.22
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$835.33 / $1,076.09 / $1,489.27
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,039.13 / $1,386.17 / $2,362.13