| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,089.30 | $2,754.23 | $3,981.07 | |
United
| Facility | $2,818.38 | $5,128.61 | $10,000.00 |
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 | $2,089.30 | $2,754.23 | $3,981.07 | |
United
| Facility | $2,818.38 | $5,128.61 | $10,000.00 |