| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $436.52 | $645.65 | $7,762.47 | |
Providence
| Facility | $436.52 | $588.84 | $1,023.29 | |
United
| Facility | $645.65 | $6,606.93 | $23,442.29 |
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 | $436.52 | $645.65 | $7,762.47 | |
Providence
| Facility | $436.52 | $588.84 | $1,023.29 | |
United
| Facility | $645.65 | $6,606.93 | $23,442.29 |