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Montana rates for HCPCS G6017

Intra-fraction localization and tracking of target or patient motion during delivery of radiation therapy (e.g., 3D positional tracking, gating, 3D surface tracking), each fraction of treatment

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.42 / $123.34 / $309.98
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$139.86 / $139.86 / $139.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.14 / $73.14 / $139.86
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$139.86 / $139.86 / $139.86
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.14 / $127.13 / $139.86
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.53 / $118.91 / $177.46