| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $616.60 | $616.60 | $616.60 | |
MountainHealth Co-op
| Facility | $660.69 | $812.83 | $870.96 | |
Providence
| Facility | $398.11 | $630.96 | $891.25 |
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 | $616.60 | $616.60 | $616.60 | |
MountainHealth Co-op
| Facility | $660.69 | $812.83 | $870.96 | |
Providence
| Facility | $398.11 | $630.96 | $891.25 |