| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Horizon BCBS
| Professional | $123.03 | $186.21 | $281.84 |
Intro Cath In Renal Pelvis Drg&/Njx Prq Rs&I
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Horizon BCBS
| Professional | $123.03 | $186.21 | $281.84 |