| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $154.35 | $198.57 | $499.65 | |
Medica
| Professional | $775.00 | $775.00 | $775.00 |
Brachytherapy isodose plan; simple (calculation made from single plane, one to four sources/ribbon application, remote afterloading brachytherapy, 1 to 8 sources)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $154.35 | $198.57 | $499.65 | |
Medica
| Professional | $775.00 | $775.00 | $775.00 |