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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
$245.47 / $676.08 / $1,071.52
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.17 / $239.88 / $512.86
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.80 / $309.03 / $446.68
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.15 / $295.12 / $446.68
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$588.84 / $831.76 / $1,348.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.82 / $316.23 / $645.65
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.05 / $512.86 / $562.34
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.04 / $208.93 / $257.04
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$173.78 / $316.23 / $467.74
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$112.20 / $363.08 / $1,202.26
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.65 / $363.08 / $1,230.27
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.95 / $213.80 / $3,388.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.03 / $288.40 / $524.81