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Rhode Island rates for HCPCS C9064

Mitomycin pyelocalyceal instillation, 1 mg

Insurance Carrier
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$272.54 / $283.23 / $299.26
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$288.58 / $288.58 / $288.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$283.22 / $283.22 / $339.33