go back

Utah 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
Facility
Modifier
Low / Median / High Price
$123.34 / $123.34 / $123.34
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.91 / $123.34 / $483.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.14 / $73.14 / $73.14
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.00 / $282.18 / $308.44
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.45 / $83.84 / $101.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.74 / $118.91 / $184.63