| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $304.11 | $304.11 | $364.93 | |
Aetna
| Professional | $104.22 | $304.11 | $304.11 | |
Harvard Pilgrim
| Professional | $162.84 | $180.04 | $237.65 |
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 | $304.11 | $304.11 | $364.93 | |
Aetna
| Professional | $104.22 | $304.11 | $304.11 | |
Harvard Pilgrim
| Professional | $162.84 | $180.04 | $237.65 |