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Wyoming 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
$741.96 / $989.17 / $1,877.30
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$246.29 / $246.29 / $246.29
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$487.00 / $874.00 / $874.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$330.12 / $330.12 / $923.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$222.17 / $438.59 / $755.29