| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $269.15 | $281.84 | $338.84 | |
Molina
| Professional | $30.20 | $30.20 | $30.20 |
Mitomycin pyelocalyceal instillation, 1 mg
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $269.15 | $281.84 | $338.84 | |
Molina
| Professional | $30.20 | $30.20 | $30.20 |