| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $19.05 | $19.05 | $19.05 |
Medcost
| Professional | 26 | $45.71 | $45.71 | $45.71 |
Urography, infusion, drip technique and/or bolus technique; with nephrotomography
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $19.05 | $19.05 | $19.05 |
Medcost
| Professional | 26 | $45.71 | $45.71 | $45.71 |