| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,074.00 | $4,450.00 | $8,031.00 | |
Anthem BCBS
| Facility | $8,217.00 | $8,931.00 | $11,908.00 | |
United
| Facility | $4,565.00 | $7,010.00 | $11,152.00 |
Dilation of existing tract, percutaneous, for an endourologic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, with postprocedure tube placement, when performed
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,074.00 | $4,450.00 | $8,031.00 | |
Anthem BCBS
| Facility | $8,217.00 | $8,931.00 | $11,908.00 | |
United
| Facility | $4,565.00 | $7,010.00 | $11,152.00 |