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Michigan rates for HCPCS 77768

Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter over 2.0 cm and 2 or more channels, or multiple lesions

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$85.11 / $87.10 / $87.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$263.03 / $363.08 / $457.09
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $549.54 / $588.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.59 / $426.58 / $794.33
Health Alliance Plan
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$58.88 / $144.54 / $162.18
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$263.03 / $346.74 / $467.74
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$281.84 / $398.11 / $794.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.59 / $407.38 / $549.54