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Minnesota rates for HCPCS C9064

Mitomycin pyelocalyceal instillation, 1 mg

Insurance Carrier
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$494.54 / $737.12 / $875.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.86 / $313.50 / $339.33
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$426.57 / $670.11 / $933.66
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$267.19 / $267.19 / $285.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$400.80 / $400.80 / $400.80