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Pennsylvania 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
$870.96 / $1,380.38 / $7,079.46
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $977.24 / $2,398.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $1,621.81 / $3,235.94
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,258.93 / $1,348.96 / $1,698.24
Geisinger
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $1,174.90 / $2,238.72
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.27 / $1,584.89 / $1,949.84
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $1,548.82 / $5,370.32
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,778.28 / $1,995.26 / $2,754.23
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $954.99 / $1,047.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $1,380.38 / $2,290.87