| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $20.69 | $25.63 | $39.02 |
Cigna
| Facility | 26 | $26.26 | $26.26 | $26.26 |
Medcost
| Facility | 26 | $35.47 | $41.00 | $71.59 |
Wellcare
| Facility | 26 | $73.63 | $117.00 | $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 | $20.69 | $25.63 | $39.02 |
Cigna
| Facility | 26 | $26.26 | $26.26 | $26.26 |
Medcost
| Facility | 26 | $35.47 | $41.00 | $71.59 |
Wellcare
| Facility | 26 | $73.63 | $117.00 | $117.00 |