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Montana rates for HCPCS 77522

Proton treatment delivery; simple, with compensation

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $954.99 / $1,174.90
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,479.11 / $1,862.09 / $5,623.41
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,318.26 / $1,621.81 / $3,311.31
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,318.26 / $1,621.81 / $3,311.31
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$831.76 / $1,548.82 / $5,623.41
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.76 / $1,258.93 / $2,137.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.52 / $1,202.26 / $1,584.89