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Utah rates for HCPCS 77522

Proton Tx Delivery Simple W/Compensation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,832.07 / $1,832.07 / $1,832.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,832.07 / $1,832.07 / $1,832.07
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,338.94 / $1,637.30 / $5,183.37
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.00 / $60.00 / $60.00
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,139.94 / $2,730.27 / $3,919.70
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,378.59 / $1,531.77 / $1,633.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$892.62 / $1,115.78 / $1,472.82