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Maine rates for HCPCS G0340

Image-Guided Robotic Linear Accelerator-Based Sterotactic Radiosurgery Delivery Including Collimator Changes And Custom Plugging Fractionated Treatment All Lesions Per Session Second Through Fifth Sessions Maximum Five Sessions Per Course Of Treatment

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,812.68 / $4,000.62 / $4,600.71
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$846.55 / $846.55 / $947.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,316.69 / $2,316.69 / $2,316.69
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,010.71 / $4,640.39 / $8,706.45
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,812.68 / $4,162.24 / $4,600.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,612.39 / $4,042.50 / $6,581.86