Imaging/Radiation Therapy Centers — Reimbursement Schedules

Blue Choice PPOSM, Blue Essentials HMOSM (formerly, HMO Blue TexasSM), Traditional, Blue Advantage HMOSM, Blue PremierSM Reimbursement Schedules

Blue Choice, HMO Blue Texas, Traditional Reimbursement Schedules

Blue Advantage HMO Schedules (Prior to 11/1/2105)