go back

Texas 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
$212.43 / $226.22 / $950.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$226.22 / $226.22 / $226.22
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$354.22 / $895.22 / $1,561.80
Baylor Scott & White
Facility/Professional
Facility
Modifier
Low / Median / High Price
$342.39 / $427.99 / $1,619.29
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$364.19 / $364.19 / $364.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$348.00 / $348.00 / $348.00
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$545.45 / $545.45 / $545.45
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$226.22 / $294.08 / $642.10
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$226.22 / $294.08 / $642.10
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$348.00 / $348.00 / $348.00