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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
$1,033.00 / $1,838.67 / $7,105.75
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$717.61 / $717.61 / $717.61
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$932.85 / $968.06 / $2,408.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,322.88 / $1,926.49 / $5,992.28
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,117.15 / $1,550.94 / $2,112.77
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.76 / $1,626.92 / $1,944.16
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,033.00 / $1,787.74 / $7,105.74
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,320.08 / $1,760.10 / $2,801.50
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,322.88 / $1,926.49 / $5,992.28
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$930.49 / $950.51 / $1,046.46
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,037.95 / $1,397.78 / $2,299.71