| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | 26 | $35.75 | $35.75 | $44.20 |
Providence
| Facility | 26 | $35.75 | $35.75 | $44.20 |
Urography, infusion, drip technique and/or bolus technique; with nephrotomography
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | 26 | $35.75 | $35.75 | $44.20 |
Providence
| Facility | 26 | $35.75 | $35.75 | $44.20 |