| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $21.94 | $41.58 | $55.08 |
Hally Health
| Professional | 26 | $28.25 | $39.96 | $91.30 |
Hally Health
| Facility | 26 | $100.00 | $100.00 | $100.00 |
Urography Nfs Drip &/Bolus W/Nephrotomography
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $21.94 | $41.58 | $55.08 |
Hally Health
| Professional | 26 | $28.25 | $39.96 | $91.30 |
Hally Health
| Facility | 26 | $100.00 | $100.00 | $100.00 |