go back

New Hampshire rates for HCPCS C2641

Brachytherapy Source Non-Stranded Palladium-103

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$76.29 / $76.29 / $91.55
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.50 / $76.29 / $76.29
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.68 / $6.68 / $6.68
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$119.56 / $119.56 / $119.56
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.77 / $88.19 / $116.42