| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $276.97 | $335.97 | $1,400.00 | |
CareSource
| Facility | $310.27 | $344.83 | $375.71 | |
Cigna
| Facility | $497.52 | $497.52 | $497.52 |
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 | $276.97 | $335.97 | $1,400.00 | |
CareSource
| Facility | $310.27 | $344.83 | $375.71 | |
Cigna
| Facility | $497.52 | $497.52 | $497.52 |