go back

Utah rates for HCPCS C2634

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$302.00 / $1,380.38 / $1,380.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.71 / $104.71 / $302.00
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$245.47 / $288.40 / $776.25
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $85.11 / $85.11