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South Dakota rates for HCPCS C2635

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

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