| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $977.24 | $5,888.44 | $14,125.38 | |
Moda Health
| Facility | $363.08 | $524.81 | $2,089.30 | |
Providence
| Facility | $575.44 | $1,479.11 | $2,511.89 |
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 | $977.24 | $5,888.44 | $14,125.38 | |
Moda Health
| Facility | $363.08 | $524.81 | $2,089.30 | |
Providence
| Facility | $575.44 | $1,479.11 | $2,511.89 |