| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $269.15 | $295.12 | $338.84 | |
Priority Health
| Professional | $269.15 | $281.84 | $302.00 |
Mitomycin pyelocalyceal instillation, 1 mg
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $269.15 | $295.12 | $338.84 | |
Priority Health
| Professional | $269.15 | $281.84 | $302.00 |