| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $689.60 | $4,450.00 | $8,031.00 | |
Anthem BCBS
| Facility | $2,826.00 | $4,945.58 | $13,227.00 | |
United
| Facility | $4,565.00 | $7,010.00 | $11,152.00 |
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 | $689.60 | $4,450.00 | $8,031.00 | |
Anthem BCBS
| Facility | $2,826.00 | $4,945.58 | $13,227.00 | |
United
| Facility | $4,565.00 | $7,010.00 | $11,152.00 |