| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $294.33 | $362.18 | $8,500.00 | |
Medica
| Facility | $294.33 | $407.39 | $882.99 |
Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service;
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $294.33 | $362.18 | $8,500.00 | |
Medica
| Facility | $294.33 | $407.39 | $882.99 |