| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $283.22 | $283.22 | $339.33 | |
MVP Health Care
| Professional | $283.22 | $283.22 | $339.33 |
Mitomycin pyelocalyceal instillation, 1 mg
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $283.22 | $283.22 | $339.33 | |
MVP Health Care
| Professional | $283.22 | $283.22 | $339.33 |