| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,691.53 | $5,495.41 | $10,715.19 | |
Horizon BCBS
| Facility | $10,964.78 | $16,218.10 | $25,703.96 | |
United
| Facility | $2,951.21 | $6,606.93 | $10,964.78 |
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 | $2,691.53 | $5,495.41 | $10,715.19 | |
Horizon BCBS
| Facility | $10,964.78 | $16,218.10 | $25,703.96 | |
United
| Facility | $2,951.21 | $6,606.93 | $10,964.78 |