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Arizona rates for HCPCS C1717

Brachytherapy source, nonstranded, high dose rate iridium-192, per source

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$432.75 / $517.76 / $1,532.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.73 / $309.50 / $491.81
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$202.31 / $768.31 / $1,217.10
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.38 / $186.03 / $370.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$348.00 / $348.00 / $348.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $309.50 / $442.59