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Idaho rates for HCPCS 77412

Radiation treatment delivery; Level 3, multiple isocenters with photon therapy (eg, 2D, 3D, or IMRT) or a single-isocenter photon therapy (eg, 3D or IMRT) with active motion management, or total skin electrons, or mixed-electron/photon field(s), including imaging guidance, when performed

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$512.86 / $977.24 / $1,513.56
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$229.09 / $281.84 / $645.65
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$302.00 / $512.86 / $912.01
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $416.87 / $426.58
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$331.13 / $676.08 / $812.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.59 / $371.54 / $478.63
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$234.42 / $512.86 / $1,258.93
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.59 / $776.25 / $1,230.27
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $30.20 / $30.20
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$467.74 / $676.08 / $912.01
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.58 / $467.74 / $524.81
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$407.38 / $407.38 / $851.14
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.93 / $316.23 / $501.19