| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Horizon BCBS
| Facility | $266.13 | $13,785.00 | $13,785.00 | |
Horizon BCBS
| Professional | $272.54 | $272.54 | $272.54 |
Mitomycin pyelocalyceal instillation, 1 mg
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Horizon BCBS
| Facility | $266.13 | $13,785.00 | $13,785.00 | |
Horizon BCBS
| Professional | $272.54 | $272.54 | $272.54 |