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Idaho rates for HCPCS 77387

Guidance for localization of target volume for delivery of radiation treatment, includes intrafraction tracking, when performed

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$175.88 / $274.69 / $506.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.03 / $123.16 / $230.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$135.41 / $277.91 / $279.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.83 / $156.66 / $214.10
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$123.16 / $230.84 / $263.16
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$315.36 / $315.36 / $315.36
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $3,900.00
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.58 / $263.04 / $263.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.31 / $103.73 / $145.68