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New Hampshire 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
$84.51 / $84.51 / $84.51
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$180.15 / $233.08 / $233.08
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$243.25 / $345.47 / $500.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$325.01 / $554.05 / $766.82
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$282.67 / $531.85 / $990.77
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$282.20 / $329.11 / $1,052.64
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$193.48 / $212.83 / $270.87