| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $34.67 | $34.67 | $47.86 |
Cigna
| Facility | 26 | $60.26 | $70.79 | $112.20 |
Medica
| Facility | 26 | $117.49 | $117.49 | $117.49 |
Quartz
| Facility | 26 | $100.00 | $144.54 | $144.54 |
Urography, infusion, drip technique and/or bolus technique; with nephrotomography
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $34.67 | $34.67 | $47.86 |
Cigna
| Facility | 26 | $60.26 | $70.79 | $112.20 |
Medica
| Facility | 26 | $117.49 | $117.49 | $117.49 |
Quartz
| Facility | 26 | $100.00 | $144.54 | $144.54 |