| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $207.33 | $1,064.46 | $8,500.00 | |
Medica
| Facility | $207.33 | $1,064.46 | $1,809.58 |
Plmt Urtrl Stent Prq Pre-Existing Nfros Tract
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $207.33 | $1,064.46 | $8,500.00 | |
Medica
| Facility | $207.33 | $1,064.46 | $1,809.58 |