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New Hampshire 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
$112.36 / $112.36 / $112.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$283.39 / $365.81 / $365.81
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$357.43 / $507.64 / $736.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$477.77 / $810.53 / $1,124.15
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$409.34 / $735.85 / $1,347.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$375.97 / $471.34 / $835.62
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$290.54 / $319.58 / $406.76