| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $232.97 | $232.97 | $1,600.00 | |
CareSource
| Facility | $265.68 | $294.37 | $320.73 | |
Cigna
| Facility | $278.48 | $278.48 | $278.48 |
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 | $232.97 | $232.97 | $1,600.00 | |
CareSource
| Facility | $265.68 | $294.37 | $320.73 | |
Cigna
| Facility | $278.48 | $278.48 | $278.48 |