| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $35.04 | $48.22 | $48.22 |
Cigna
| Facility | 26 | $60.38 | $70.55 | $93.77 |
Medica
| Facility | 26 | $117.00 | $117.00 | $117.00 |
Quartz
| Facility | 26 | $100.00 | $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 | $35.04 | $48.22 | $48.22 |
Cigna
| Facility | 26 | $60.38 | $70.55 | $93.77 |
Medica
| Facility | 26 | $117.00 | $117.00 | $117.00 |
Quartz
| Facility | 26 | $100.00 | $117.00 | $117.00 |