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Illinois 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
$295.12 / $741.31 / $1,071.52
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.98 / $281.84 / $794.33
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$346.74 / $354.81 / $660.69
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$295.12 / $794.33 / $3,467.37
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.00 / $363.08 / $524.81
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$263.03 / $467.74 / $933.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.17 / $309.03 / $416.87
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.53 / $346.74 / $831.76
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.04 / $269.15 / $288.40
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.81 / $39.81 / $39.81
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$218.78 / $218.78 / $1,479.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.21 / $288.40 / $467.74