| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Asuris Northwest Health
| Facility | $770.25 | $770.25 | $770.25 | |
Asuris Northwest Health
| Professional | $1,141.00 | $1,141.00 | $1,141.00 |
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 |
|---|---|---|---|---|---|
Asuris Northwest Health
| Facility | $770.25 | $770.25 | $770.25 | |
Asuris Northwest Health
| Professional | $1,141.00 | $1,141.00 | $1,141.00 |