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Pennsylvania 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
$71.59 / $124.58 / $249.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$292.45 / $345.86 / $399.27
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.71 / $542.67 / $627.29
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$83.69 / $83.69 / $83.69
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$300.43 / $424.42 / $662.26
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$417.81 / $482.09 / $576.21
Martin's Point
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$71.59 / $136.53 / $282.82
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$292.45 / $364.18 / $649.83
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.26 / $461.60 / $685.36
Priority Health
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$83.69 / $83.69 / $83.69
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$306.31 / $433.62 / $718.11
UPMC Health Plan
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$72.36 / $72.36 / $78.75
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$340.78 / $346.73 / $377.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$312.16 / $403.34 / $673.70