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New Hampshire rates for HCPCS G0339

Image guided robotic linear accelerator-based stereotactic radiosurgery, complete course of therapy in one session or first session of fractionated treatment

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,933.82 / $7,933.82 / $9,520.58
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,933.82 / $7,933.82 / $10,005.99
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$984.79 / $984.79 / $984.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,821.49 / $2,821.49 / $2,821.49
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,351.28 / $7,813.32 / $14,327.82
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,155.00 / $11,155.00 / $11,155.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$171.69 / $4,989.29 / $10,137.37
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,937.00 / $3,230.70 / $4,111.80