| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $141.25 | $151.36 | $8,511.38 | |
Medica
| Facility | $0.68 | $208.93 | $457.09 | |
United
| Facility | $1,819.70 | $2,041.74 | $2,041.74 |
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 | $141.25 | $151.36 | $8,511.38 | |
Medica
| Facility | $0.68 | $208.93 | $457.09 | |
United
| Facility | $1,819.70 | $2,041.74 | $2,041.74 |