| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $19.71 | $19.71 | $19.71 |
Medcost
| Facility | 26 | $35.47 | $41.00 | $72.42 |
Urography Nfs Drip &/Bolus W/Nephrotomography
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $19.71 | $19.71 | $19.71 |
Medcost
| Facility | 26 | $35.47 | $41.00 | $72.42 |