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Washington 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
$72.44 / $151.36 / $251.19
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$281.84 / $380.19 / $794.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $741.31 / $1,202.26
Kaiser Permanente
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$95.50 / $165.96 / $1,174.90
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.63 / $794.33 / $1,023.29
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $33.11
Pacific Source
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$117.49 / $141.25 / $147.91
Premera BCBS
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$97.72 / $97.72 / $100.00
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $831.76 / $1,071.52
Regence BlueShield
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$467.74 / $467.74 / $467.74
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.78 / $758.58 / $1,023.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.59 / $457.09 / $933.25
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.05 / $524.81 / $724.44