| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,238.72 | $5,495.41 | $10,715.19 | |
Horizon BCBS
| Facility | $7,244.36 | $11,220.18 | $17,378.01 | |
United
| Facility | $2,884.03 | $6,606.93 | $10,964.78 |
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 | $2,238.72 | $5,495.41 | $10,715.19 | |
Horizon BCBS
| Facility | $7,244.36 | $11,220.18 | $17,378.01 | |
United
| Facility | $2,884.03 | $6,606.93 | $10,964.78 |