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Arizona rates for HCPCS 77767

Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter up to 2.0 cm or 1 channel

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$75.73 / $183.21 / $229.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$206.46 / $256.72 / $358.61
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$254.02 / $260.54 / $519.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$207.24 / $289.64 / $435.62
Medica
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$129.58 / $252.81 / $252.81
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$250.86 / $300.80 / $1,574.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.69 / $300.80 / $457.20