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Missouri 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
$245.47 / $758.58 / $1,071.52
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $239.88 / $512.86
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.58 / $426.58 / $660.69
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$295.12 / $371.54 / $676.08
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $134.90 / $389.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$436.52 / $512.86 / $724.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$269.15 / $831.76 / $1,023.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.98 / $295.12 / $478.63
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$190.55 / $371.54 / $1,621.81
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.18 / $295.12 / $1,548.82
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$194.98 / $199.53 / $1,737.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.21 / $275.42 / $467.74