go back

Vermont 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
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$815.75 / $1,224.66 / $1,847.04
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,558.68 / $1,558.68 / $1,558.68
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$296.11 / $380.90 / $831.00
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,558.68 / $1,558.68 / $1,558.68
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$296.11 / $385.45 / $831.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$159.07 / $250.62 / $1,070.46