| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $18.02 | $18.02 | $67.55 |
AllWays Health Partners
| Facility | 26 | $54.31 | $57.05 | $117.00 |
Mass General Brigham
| Facility | 26 | $54.52 | $117.00 | $117.00 |
Urography Nfs Drip &/Bolus W/Nephrotomography
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $18.02 | $18.02 | $67.55 |
AllWays Health Partners
| Facility | 26 | $54.31 | $57.05 | $117.00 |
Mass General Brigham
| Facility | 26 | $54.52 | $117.00 | $117.00 |