| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $414.45 | $5,559.00 | $10,202.00 | |
Horizon BCBS
| Facility | $6,766.81 | $7,684.77 | $17,029.74 | |
United
| Facility | $5,378.00 | $8,305.00 | $14,121.00 |
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 | $414.45 | $5,559.00 | $10,202.00 | |
Horizon BCBS
| Facility | $6,766.81 | $7,684.77 | $17,029.74 | |
United
| Facility | $5,378.00 | $8,305.00 | $14,121.00 |