| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $604.41 | $604.41 | $725.29 | |
Aetna
| Professional | $51.12 | $604.41 | $604.41 | |
Harvard Pilgrim
| Professional | $69.38 | $76.70 | $101.25 |
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 | $604.41 | $604.41 | $725.29 | |
Aetna
| Professional | $51.12 | $604.41 | $604.41 | |
Harvard Pilgrim
| Professional | $69.38 | $76.70 | $101.25 |