go back

Louisiana 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
$359.99 / $539.99 / $1,285.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$313.24 / $371.25 / $408.37
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$187.40 / $357.81 / $568.02
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$370.21 / $602.79 / $776.41
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$331.38 / $331.38 / $331.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$262.98 / $621.20 / $881.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$139.22 / $214.59 / $406.05
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.82 / $247.29 / $467.20