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Indiana 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
$416.87 / $977.24 / $1,621.81
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.98 / $239.88 / $741.31
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$346.74 / $346.74 / $660.69
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$162.18 / $162.18 / $309.03
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.36 / $169.82 / $323.59
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$204.17 / $269.15 / $309.03
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.17 / $234.42 / $288.40
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$263.03 / $263.03 / $2,454.71
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.82 / $245.47 / $407.38
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$218.78 / $218.78 / $229.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.96 / $245.47 / $426.58