| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | AA | $1,092.42 | $1,092.42 | $1,092.42 |
Aetna
| Facility | QK | $433.16 | $572.22 | $999.50 |
Aetna
| Facility | QX | $356.72 | $611.07 | $990.08 |
Anes Trurl Fragmntj Manj&/Rmvl Ureteral Calculus
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | AA | $1,092.42 | $1,092.42 | $1,092.42 |
Aetna
| Facility | QK | $433.16 | $572.22 | $999.50 |
Aetna
| Facility | QX | $356.72 | $611.07 | $990.08 |