| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Molina
| Professional | $2,517.64 | $2,517.64 | $2,751.89 |
Pyelotomy Complicated
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Molina
| Professional | $2,517.64 | $2,517.64 | $2,751.89 |