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Washington 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
$92.62 / $92.62 / $92.62
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.13 / $123.34 / $155.40
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$111.89 / $437.21 / $437.21
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.11 / $194.56 / $774.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.14 / $73.14 / $73.14
Kaiser Permanente
Facility/Professional
Facility
Modifier
Low / Median / High Price
$96.33 / $188.10 / $317.26
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.88 / $188.10 / $317.26
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.00 / $75.00 / $75.00
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.51 / $107.61 / $177.03
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$111.89 / $111.89 / $121.56
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$127.33 / $193.87 / $241.29
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.11 / $169.71 / $228.49
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.24 / $118.91 / $233.82