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Indiana rates for HCPCS C9064

Mitomycin pyelocalyceal instillation, 1 mg

Insurance Carrier
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$339.88 / $339.88 / $513.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.86 / $283.22 / $339.33