| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medcost
| Facility | $187.35 | $282.00 | $332.31 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |
Brachytherapy isodose plan; intermediate (multiplane dosage calculations, application involving 5 to 10 sources/ribbons, remote afterloading brachytherapy, 9 to 12 sources
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medcost
| Facility | $187.35 | $282.00 | $332.31 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |