| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,872.00 | $8,303.41 | $13,413.92 | |
Moda Health
| Facility | $318.36 | $1,180.47 | $1,688.07 | |
Providence
| Facility | $318.36 | $1,180.47 | $1,688.07 |
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; including new access into the renal collecting system
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,872.00 | $8,303.41 | $13,413.92 | |
Moda Health
| Facility | $318.36 | $1,180.47 | $1,688.07 | |
Providence
| Facility | $318.36 | $1,180.47 | $1,688.07 |