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New Hampshire 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
$562.34 / $870.96 / $1,047.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.48 / $223.87 / $870.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$346.74 / $346.74 / $346.74
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $354.81 / $537.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.84 / $354.81 / $794.33