| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | $676.16 | $676.16 | $676.16 | |
Medcost
| Professional | $225.00 | $252.26 | $442.00 |
Intro Guide Pelvis&/Ureter W/Dilat Nfros Tract
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | $676.16 | $676.16 | $676.16 | |
Medcost
| Professional | $225.00 | $252.26 | $442.00 |