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Utah rates for HCPCS 77763

Intracavitary Radiation Source Applic Complex

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$765.33 / $765.33 / $765.33
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.90 / $765.33 / $4,353.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$728.32 / $890.61 / $2,819.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$865.38 / $957.02 / $1,443.84
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$252.30 / $441.04 / $795.43
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,106.67 / $1,468.73 / $2,426.35
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,163.95 / $1,412.38 / $1,501.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$772.32 / $965.40 / $1,274.33