| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Premera BCBS
| Professional | $4,911.00 | $6,446.00 | $7,240.81 | |
Providence
| Professional | $1,734.98 | $4,858.50 | $7,240.81 |
Pyelotomy; complicated (eg, secondary operation, congenital kidney abnormality)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Premera BCBS
| Professional | $4,911.00 | $6,446.00 | $7,240.81 | |
Providence
| Professional | $1,734.98 | $4,858.50 | $7,240.81 |