| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $313.98 | $387.25 | $8,500.00 | |
Medica
| Facility | $313.98 | $435.08 | $941.94 |
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 | $313.98 | $387.25 | $8,500.00 | |
Medica
| Facility | $313.98 | $435.08 | $941.94 |