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South Dakota rates for HCPCS C2641

Brachytherapy Source Non-Stranded Palladium-103

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.44 / $3.44 / $3.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.44 / $3.44 / $3.44
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.92 / $5.81 / $9.43
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$119.66 / $119.66 / $139.60