| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,513.56 | $1,548.82 | $3,981.07 | |
United
| Facility | $2,570.40 | $4,677.35 | $7,585.78 |
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 | $1,513.56 | $1,548.82 | $3,981.07 | |
United
| Facility | $2,570.40 | $4,677.35 | $7,585.78 |