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Missouri 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
$50.12 / $223.87 / $575.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.98 / $223.87 / $309.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$346.74 / $346.74 / $346.74
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$223.87 / $331.13 / $912.01
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$275.42 / $275.42 / $1,096.48