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Virginia rates for HCPCS 77772

Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; over 12 channels

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$252.44 / $446.52 / $1,043.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$791.19 / $847.47 / $1,540.88
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$824.03 / $1,047.65 / $1,462.30
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,081.55 / $1,081.55 / $4,087.28
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$320.77 / $320.77 / $320.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$814.61 / $1,199.81 / $2,247.69
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$900.88 / $1,231.07 / $1,293.14
Kaiser Permanente
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$279.33 / $366.17 / $381.43
Medcost
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$478.17 / $478.17 / $834.79
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$352.00 / $913.00 / $1,525.00
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$343.59 / $1,033.24 / $1,993.57
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$731.91 / $1,159.05 / $1,703.26