| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Providence
| Facility | $154.88 | $239.88 | $323.59 |
Intro Cath In Renal Pelvis Drg&/Njx Prq Rs&I
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Providence
| Facility | $154.88 | $239.88 | $323.59 |