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Arizona rates for HCPCS C9064

Mitomycin pyelocalyceal instillation, 1 mg

Insurance Carrier
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.15 / $295.12 / $338.84
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$275.42 / $275.42 / $1,380.38
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.11 / $398.11 / $398.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.59 / $323.59 / $323.59