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South Dakota rates for HCPCS C2642

Brachytherapy source, stranded, cesium-131, per source

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$88.00 / $88.00 / $88.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$88.00 / $160.75 / $160.75
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$125.84 / $271.67 / $440.46
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$161.79 / $161.79 / $188.76