| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $321.08 | $384.07 | $1,400.00 | |
CareSource
| Facility | $401.15 | $401.15 | $437.05 | |
Cigna
| Facility | $578.20 | $578.20 | $578.20 |
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 | $321.08 | $384.07 | $1,400.00 | |
CareSource
| Facility | $401.15 | $401.15 | $437.05 | |
Cigna
| Facility | $578.20 | $578.20 | $578.20 |