| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $51.12 | $51.12 | $51.12 | |
Aetna
| Professional | $49.81 | $49.81 | $51.12 | |
Medica
| Facility | $71.23 | $84.18 | $136.47 | |
Midlands
| Facility | $104.07 | $104.07 | $121.42 |
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 | $49.81 | $49.81 | $51.12 | |
Medica
| Facility | $71.23 | $84.18 | $136.47 | |
Midlands
| Facility | $104.07 | $104.07 | $121.42 |