go back

Virginia 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
$247.30 / $776.75 / $1,079.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$210.47 / $235.59 / $410.44
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.81 / $255.86 / $378.28
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.14 / $295.20 / $365.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$237.64 / $639.13 / $1,187.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.15 / $332.27 / $669.81
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$219.83 / $306.94 / $314.93
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$151.62 / $291.74 / $414.64
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$277.00 / $337.00 / $541.27
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$110.35 / $349.95 / $841.00
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.35 / $356.73 / $859.79
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$122.65 / $313.69 / $535.14