| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $269.86 | $283.22 | $339.33 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |
Mitomycin pyelocalyceal instillation, 1 mg
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $269.86 | $283.22 | $339.33 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |