| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $51.29 | $95.50 | $95.50 | |
Aetna
| Professional | $48.98 | $51.29 | $51.29 | |
Medica
| Facility | $51.29 | $53.70 | $147.91 | |
United
| Facility | $45.71 | $154.88 | $269.15 |
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 | $51.29 | $95.50 | $95.50 | |
Aetna
| Professional | $48.98 | $51.29 | $51.29 | |
Medica
| Facility | $51.29 | $53.70 | $147.91 | |
United
| Facility | $45.71 | $154.88 | $269.15 |