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South Dakota rates for HCPCS 77435

Stereotactic body radiation therapy, treatment management, per treatment course, to 1 or more lesions, including image guidance, entire course not to exceed 5 fractions

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$645.65 / $645.65 / $954.99
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616.60 / $691.83 / $2,238.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,380.38 / $1,513.56 / $1,905.46
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$707.95 / $954.99 / $1,548.82
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616.60 / $870.96 / $1,698.24
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,479.11 / $1,479.11 / $1,479.11
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.14 / $1,071.52 / $1,258.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $1,000.00 / $1,412.54
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,202.26 / $1,412.54 / $1,412.54