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Arizona rates for HCPCS C2635

Brachytherapy source, nonstranded, high activity, palladium-103, greater than 2.2 mCi (NIST), per source

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.81 / $51.12 / $604.41
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.14 / $72.72 / $115.20
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.30 / $22.87 / $45.60
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$49.81 / $51.12 / $100.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.50 / $55.50 / $55.50