| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $302.75 | $4,294.00 | $9,842.00 | |
Horizon BCBS
| Facility | $9,973.98 | $10,303.25 | $23,570.44 | |
United
| Facility | $3,705.00 | $5,265.00 | $10,536.00 |
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 | $302.75 | $4,294.00 | $9,842.00 | |
Horizon BCBS
| Facility | $9,973.98 | $10,303.25 | $23,570.44 | |
United
| Facility | $3,705.00 | $5,265.00 | $10,536.00 |