| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $18.60 | $22.66 | $127.60 |
Cigna
| Facility | 26 | $22.46 | $22.46 | $36.06 |
Medica
| Facility | 26 | $54.52 | $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 | $18.60 | $22.66 | $127.60 |
Cigna
| Facility | 26 | $22.46 | $22.46 | $36.06 |
Medica
| Facility | 26 | $54.52 | $117.00 | $117.00 |