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Utah 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
$977.24 / $1,202.26 / $6,918.31
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $2,398.83
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,479.11 / $1,737.80 / $2,570.40
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $1,737.80 / $2,818.38
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,258.93 / $1,548.82 / $2,089.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.27 / $1,778.28 / $2,454.71