| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,388.99 | $6,541.00 | $13,413.92 | |
Moda Health
| Facility | $496.75 | $2,196.69 | $3,075.37 | |
Providence
| Facility | $496.75 | $2,196.69 | $3,075.37 |
Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,388.99 | $6,541.00 | $13,413.92 | |
Moda Health
| Facility | $496.75 | $2,196.69 | $3,075.37 | |
Providence
| Facility | $496.75 | $2,196.69 | $3,075.37 |