| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $676.08 | $676.08 | $812.83 | |
Pacific Source
| Facility | $251.19 | $338.84 | $346.74 |
Intro Guide Pelvis&/Ureter W/Dilat Nfros Tract
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $676.08 | $676.08 | $812.83 | |
Pacific Source
| Facility | $251.19 | $338.84 | $346.74 |