| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,235.94 | $3,235.94 | $7,244.36 | |
United
| Facility | $1,000.00 | $1,000.00 | $1,000.00 |
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 | $3,235.94 | $3,235.94 | $7,244.36 | |
United
| Facility | $1,000.00 | $1,000.00 | $1,000.00 |