| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $173.01 | $173.01 | $173.01 |
Intro Cath In Renal Pelvis Drg&/Njx Prq Rs&I
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $173.01 | $173.01 | $173.01 |