| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,017.00 | $4,004.00 | $4,601.00 | |
Kaiser Permanente
| Professional | $252.75 | $539.67 | $539.67 | |
United
| Facility | $2,648.00 | $3,378.00 | $26,408.00 |
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; including new access into the renal collecting system
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,017.00 | $4,004.00 | $4,601.00 | |
Kaiser Permanente
| Professional | $252.75 | $539.67 | $539.67 | |
United
| Facility | $2,648.00 | $3,378.00 | $26,408.00 |