| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $22.15 | $40.33 | $80.98 |
Cigna
| Facility | 26 | $26.26 | $26.26 | $28.89 |
Medical Mutual of Ohio
| Facility | 26 | $26.26 | $26.26 | $28.89 |
Urography, infusion, drip technique and/or bolus technique; with nephrotomography
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $22.15 | $40.33 | $80.98 |
Cigna
| Facility | 26 | $26.26 | $26.26 | $28.89 |
Medical Mutual of Ohio
| Facility | 26 | $26.26 | $26.26 | $28.89 |