| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $724.44 | $912.01 | $1,258.93 | |
Cigna
| Professional | $616.60 | $977.24 | $1,621.81 | |
United
| Professional | $758.58 | $1,071.52 | $2,951.21 |
Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with endopyelotomy (includes cystoscopy, ureteroscopy, dilation of ureter and ureteral pelvic junction, incision of ureteral pelvic junction and insertion of endopyelotomy stent)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $724.44 | $912.01 | $1,258.93 | |
Cigna
| Professional | $616.60 | $977.24 | $1,621.81 | |
United
| Professional | $758.58 | $1,071.52 | $2,951.21 |