| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Harvard Pilgrim
| Professional | $4.69 | $5.19 | $6.84 | |
Well Sense
| Professional | $2,500.00 | $2,750.00 | $3,500.00 |
Brachytherapy Planar Source Palladium-103 Per Square Millimeter
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Harvard Pilgrim
| Professional | $4.69 | $5.19 | $6.84 | |
Well Sense
| Professional | $2,500.00 | $2,750.00 | $3,500.00 |