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Michigan 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
$226.22 / $549.04 / $885.61
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$226.22 / $226.22 / $309.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$348.00 / $348.00 / $348.00
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$230.29 / $400.25 / $885.61
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$226.22 / $226.22 / $297.68
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $100.00