| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $22.91 | $22.91 | $27.54 |
Hometown Health
| Professional | 26 | $0.27 | $26.92 | $36.31 |
Urography, infusion, drip technique and/or bolus technique; with nephrotomography
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $22.91 | $22.91 | $27.54 |
Hometown Health
| Professional | 26 | $0.27 | $26.92 | $36.31 |