go back

Washington rates for HCPCS C2639

Brachytherapy source, nonstranded, iodine-125, per source

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.92 / $45.71 / $45.71
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.00 / $26.92 / $34.67
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.11 / $85.11 / $85.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.77 / $46.77 / $46.77
Kaiser Permanente
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.67 / $104.71 / $181.97
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.65 / $43.65 / $43.65
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.57 / $64.57 / $75.86
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.67 / $89.13 / $89.13
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79.43 / $104.71 / $199.53
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $134.90 / $245.47