| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $1,071.52 | $1,318.26 | $1,819.70 | |
Cigna
| Professional | $891.25 | $1,412.54 | $2,344.23 | |
United
| Professional | $1,096.48 | $1,479.11 | $4,265.80 |
Pyelotomy; with removal of calculus (pyelolithotomy, pelviolithotomy, including coagulum pyelolithotomy)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $1,071.52 | $1,318.26 | $1,819.70 | |
Cigna
| Professional | $891.25 | $1,412.54 | $2,344.23 | |
United
| Professional | $1,096.48 | $1,479.11 | $4,265.80 |