| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $269.15 | $281.84 | $338.84 | |
Medica
| Facility | $275.42 | $1,380.38 | $1,380.38 | |
Medica
| Professional | $398.11 | $398.11 | $398.11 |
Mitomycin pyelocalyceal instillation, 1 mg
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $269.15 | $281.84 | $338.84 | |
Medica
| Facility | $275.42 | $1,380.38 | $1,380.38 | |
Medica
| Professional | $398.11 | $398.11 | $398.11 |