| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $296.02 | $360.15 | $1,400.00 | |
CareSource
| Facility | $331.31 | $368.12 | $401.09 | |
Cigna
| Facility | $531.24 | $531.24 | $531.24 |
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 | $296.02 | $360.15 | $1,400.00 | |
CareSource
| Facility | $331.31 | $368.12 | $401.09 | |
Cigna
| Facility | $531.24 | $531.24 | $531.24 |