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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
$86.60 / $86.60 / $86.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$266.35 / $408.62 / $408.62
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.55 / $550.27 / $612.05
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$325.07 / $510.49 / $787.02
Health Alliance Plan
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$54.87 / $54.87 / $86.60
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$264.58 / $304.27 / $464.07
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.49 / $286.46 / $408.77
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$319.98 / $398.10 / $550.64