| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $51.12 | $51.12 | $51.12 | |
Aetna
| Professional | $51.12 | $51.12 | $604.41 | |
Medica
| Facility | $51.12 | $76.27 | $185.19 | |
United
| Facility | $55.50 | $55.50 | $59.45 |
Brachytherapy source, nonstranded, high activity, palladium-103, greater than 2.2 mCi (NIST), per source
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $51.12 | $51.12 | $51.12 | |
Aetna
| Professional | $51.12 | $51.12 | $604.41 | |
Medica
| Facility | $51.12 | $76.27 | $185.19 | |
United
| Facility | $55.50 | $55.50 | $59.45 |