| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $741.31 | $3,548.13 | $7,943.28 | |
Medica
| Facility | $371.54 | $630.96 | $6,456.54 | |
United
| Facility | $1,548.82 | $3,630.78 | $5,623.41 |
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 | $741.31 | $3,548.13 | $7,943.28 | |
Medica
| Facility | $371.54 | $630.96 | $6,456.54 | |
United
| Facility | $1,548.82 | $3,630.78 | $5,623.41 |