| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Hally Health
| Professional | $120.00 | $345.40 | $345.40 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 |
Introduction Of Ureteral Catheter Or Stent Into Ureter Through Renal Pelvis For Drainage And/Or Injection, Percutaneou
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Hally Health
| Professional | $120.00 | $345.40 | $345.40 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 |