go back

South Dakota rates for HCPCS C1717

Brachytherapy Source Non-Stranded High Dose Rateiridum-192 Per Source

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$226.22 / $226.22 / $226.22
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$226.22 / $309.50 / $309.50
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$117.81 / $523.05 / $1,134.27
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$513.59 / $513.59 / $599.17