| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $407.38 | $602.56 | $7,762.47 | |
Providence
| Facility | $380.19 | $524.81 | $933.25 | |
United
| Facility | $562.34 | $4,365.16 | $23,442.29 |
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 | $407.38 | $602.56 | $7,762.47 | |
Providence
| Facility | $380.19 | $524.81 | $933.25 | |
United
| Facility | $562.34 | $4,365.16 | $23,442.29 |