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Wisconsin rates for HCPCS 77523

Proton Tx Delivery Intermediate

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$200.00 / $200.00 / $200.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,378.19 / $2,870.13 / $2,870.13
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$976.49 / $1,982.27 / $6,177.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,506.92 / $2,929.53 / $4,493.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,514.87 / $4,045.20 / $4,596.81
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$960.00 / $1,452.11 / $1,913.66
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,022.78 / $1,452.11 / $2,495.77
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.48 / $1,983.93 / $7,344.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.00 / $88.58 / $3,241.95
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$960.00 / $1,452.11 / $1,913.66
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,753.92 / $2,562.02 / $3,572.80
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,915.35 / $4,915.35 / $4,915.35
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,944.67 / $5,003.50 / $7,344.00
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,960.88 / $2,960.88 / $2,960.88
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,110.93 / $5,646.81 / $5,646.81
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,261.40 / $3,261.40 / $4,205.49
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$250.41 / $1,679.18 / $3,934.83