| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $371.73 | $443.28 | $1,400.00 | |
CareSource
| Facility | $416.03 | $462.64 | $504.05 | |
Cigna
| Facility | $667.09 | $667.09 | $667.09 |
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 | $371.73 | $443.28 | $1,400.00 | |
CareSource
| Facility | $416.03 | $462.64 | $504.05 | |
Cigna
| Facility | $667.09 | $667.09 | $667.09 |