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 | $545.00 | $4,542.00 | $11,576.00 | |
Cigna
| Facility | $323.00 | $1,649.96 | $1,964.23 | |
Florida Blue
| Facility | $5,855.00 | $12,742.00 | $23,031.00 | |
United
| Facility | $2,637.00 | $8,136.00 | $12,748.00 |