| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $104.22 | $104.22 | $304.11 | |
Harvard Pilgrim
| Professional | $162.84 | $162.84 | $162.84 | |
Martin's Point
| Professional | $104.22 | $104.22 | $304.11 |
Brachytherapy Source Non-Stranded High Activity Iodine-125 Greater Than 1.01 Mci (Nist) Per Source.
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $104.22 | $104.22 | $304.11 | |
Harvard Pilgrim
| Professional | $162.84 | $162.84 | $162.84 | |
Martin's Point
| Professional | $104.22 | $104.22 | $304.11 |