| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,090.73 | $2,778.87 | $3,955.04 | |
United
| Facility | $3,146.00 | $4,086.00 | $9,622.00 |
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 | $2,090.73 | $2,778.87 | $3,955.04 | |
United
| Facility | $3,146.00 | $4,086.00 | $9,622.00 |