| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $295.12 | $389.05 | $8,511.38 | |
Medica
| Facility | $316.23 | $537.03 | $1,258.93 | |
United
| Facility | $4,677.35 | $5,128.61 | $5,128.61 |
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 | $295.12 | $389.05 | $8,511.38 | |
Medica
| Facility | $316.23 | $537.03 | $1,258.93 | |
United
| Facility | $4,677.35 | $5,128.61 | $5,128.61 |