go back

Arizona rates for HCPCS C2634

Brachytherapy source, nonstranded, high activity, iodine-125, greater than 1.01 mCi (NIST), per source

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.71 / $104.71 / $302.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.15 / $120.23 / $177.83
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.86 / $47.86 / $229.09
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$104.71 / $213.80 / $316.23
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$128.82 / $128.82 / $128.82