| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $104.71 | $104.71 | $104.71 | |
Aetna
| Professional | $104.71 | $104.71 | $302.00 | |
Cigna
| Facility | $89.13 | $89.13 | $89.13 | |
United
| Facility | $208.93 | $269.15 | $501.19 |
Brachytherapy source, nonstranded, high activity, iodine-125, greater than 1.01 mCi (NIST), per source
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $104.71 | $104.71 | $104.71 | |
Aetna
| Professional | $104.71 | $104.71 | $302.00 | |
Cigna
| Facility | $89.13 | $89.13 | $89.13 | |
United
| Facility | $208.93 | $269.15 | $501.19 |