go back

Maine rates for HCPCS C2634

Brachytherapy Source Non-Stranded High Activity Iodine-125 Greater Than 1.01 Mci (Nist) Per Source.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.22 / $104.22 / $304.11
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.84 / $162.84 / $162.84
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.22 / $104.22 / $304.11