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New Hampshire rates for HCPCS 77763

Intracavitary radiation source application; complex

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,222.33 / $2,463.54 / $2,463.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$557.65 / $557.94 / $698.31
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,266.85 / $4,105.52 / $4,560.81
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$774.05 / $1,099.33 / $1,594.04
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,497.44 / $2,463.17 / $4,333.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$974.72 / $1,660.42 / $2,379.67
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$886.48 / $1,688.25 / $3,152.76
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$668.88 / $948.88 / $3,152.76
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$597.04 / $656.76 / $835.87