| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,518.41 | $1,543.03 | $3,955.04 | |
United
| Facility | $2,654.00 | $3,447.00 | $7,350.00 |
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 | $1,518.41 | $1,543.03 | $3,955.04 | |
United
| Facility | $2,654.00 | $3,447.00 | $7,350.00 |