| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $397.93 | $4,294.00 | $9,842.00 | |
Horizon BCBS
| Facility | $10,303.25 | $11,326.97 | $23,570.44 | |
United
| Facility | $4,415.00 | $7,250.00 | $10,536.00 |
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 | $397.93 | $4,294.00 | $9,842.00 | |
Horizon BCBS
| Facility | $10,303.25 | $11,326.97 | $23,570.44 | |
United
| Facility | $4,415.00 | $7,250.00 | $10,536.00 |