| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $283.22 | $283.22 | $339.33 | |
Hometown Health
| Professional | $266.13 | $320.64 | $350.00 |
Mitomycin pyelocalyceal instillation, 1 mg
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $283.22 | $283.22 | $339.33 | |
Hometown Health
| Professional | $266.13 | $320.64 | $350.00 |