| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $611.51 | $611.51 | $611.51 | |
Providence
| Facility | $371.60 | $892.45 | $918.39 |
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 |
|---|---|---|---|---|---|
Cigna
| Facility | $611.51 | $611.51 | $611.51 | |
Providence
| Facility | $371.60 | $892.45 | $918.39 |