| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $100.00 | $2,331.21 | $9,859.00 | |
Anthem BCBS
| Facility | $3,302.10 | $3,669.21 | $6,000.00 | |
United
| Facility | $9,949.00 | $9,949.00 | $9,949.00 |
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 | $100.00 | $2,331.21 | $9,859.00 | |
Anthem BCBS
| Facility | $3,302.10 | $3,669.21 | $6,000.00 | |
United
| Facility | $9,949.00 | $9,949.00 | $9,949.00 |