go back

Texas rates for HCPCS 77387

Guidance For Loclzj Target Vol For Radj Tx Dlvr

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$87.51 / $439.56 / $714.89
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.53 / $94.75 / $160.49
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$117.85 / $294.63 / $559.79
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.69 / $76.13 / $89.56
Baylor Scott & White
Facility/Professional
Facility
Modifier
Low / Median / High Price
$210.22 / $280.14 / $919.36
Baylor Scott & White
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.35 / $119.74 / $215.53
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.15 / $36.15 / $37.39
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$107.82 / $244.47 / $516.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.22 / $109.51 / $186.12
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$250.27 / $575.27 / $683.34
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$810.52 / $810.52 / $1,066.50
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$88.76 / $137.97 / $331.80
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.35 / $117.02 / $477.75
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$321.60 / $434.89 / $3,704.61
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.07 / $55.32 / $107.26
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$93.24 / $159.22 / $444.61
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.04 / $110.09 / $189.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.82 / $88.67 / $154.76
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$96.76 / $96.76 / $130.63