| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $26.52 | $31.78 | $52.29 |
Medica
| Facility | 26 | $54.52 | $54.52 | $117.00 |
Urography, infusion, drip technique and/or bolus technique; with nephrotomography
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $26.52 | $31.78 | $52.29 |
Medica
| Facility | 26 | $54.52 | $54.52 | $117.00 |