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Nebraska 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
$118.98 / $493.09 / $532.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.08 / $118.98 / $552.30
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$379.24 / $498.80 / $964.84
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$217.11 / $232.06 / $237.86
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$696.18 / $696.18 / $696.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$155.74 / $212.35 / $297.04
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$96.51 / $315.00 / $868.92
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.58 / $176.44 / $810.52
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$132.11 / $239.02 / $430.22
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$124.30 / $205.34 / $297.04
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.72 / $40.72 / $71.01
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.78 / $176.44 / $237.37