| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $25.70 | $47.86 | $51.29 |
Medica
| Facility | 26 | $54.95 | $54.95 | $117.49 |
Urography, infusion, drip technique and/or bolus technique; with nephrotomography
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $25.70 | $47.86 | $51.29 |
Medica
| Facility | 26 | $54.95 | $54.95 | $117.49 |