| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,127.03 | $6,541.00 | $13,413.92 | |
Moda Health
| Facility | $395.36 | $1,782.39 | $2,495.35 | |
Providence
| Facility | $395.36 | $1,782.39 | $2,495.35 |
Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilation of ureter
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,127.03 | $6,541.00 | $13,413.92 | |
Moda Health
| Facility | $395.36 | $1,782.39 | $2,495.35 | |
Providence
| Facility | $395.36 | $1,782.39 | $2,495.35 |