go back

California 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
$258.79 / $497.49 / $1,027.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.52 / $226.22 / $1,026.43
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.02 / $0.02
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.00 / $357.85 / $843.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$348.00 / $348.00 / $348.00
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$393.93 / $393.93 / $393.93
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $1,711.95
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$545.45 / $545.45 / $545.45
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $60.00 / $85.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$226.22 / $370.07 / $1,357.40
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$348.00 / $348.00 / $348.00