| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $343.85 | $4,294.00 | $9,860.00 | |
Horizon BCBS
| Facility | $22,481.67 | $39,900.96 | $45,659.04 | |
United
| Facility | $3,705.00 | $5,265.00 | $10,536.00 |
Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $343.85 | $4,294.00 | $9,860.00 | |
Horizon BCBS
| Facility | $22,481.67 | $39,900.96 | $45,659.04 | |
United
| Facility | $3,705.00 | $5,265.00 | $10,536.00 |