| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $22.91 | $22.91 | $22.91 |
Midlands
| Professional | 26 | $45.71 | $48.98 | $57.54 |
Sanford Health Plan
| Professional | 26 | $28.18 | $38.02 | $44.67 |
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 | $22.91 |
Midlands
| Professional | 26 | $45.71 | $48.98 | $57.54 |
Sanford Health Plan
| Professional | 26 | $28.18 | $38.02 | $44.67 |