| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $213.80 | $1,949.84 | $2,754.23 | |
Cigna
| Professional | $173.78 | $1,698.24 | $4,365.16 | |
United
| Professional | $234.42 | $1,949.84 | $5,011.87 |
Ureteral embolization or occlusion, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code for primary procedure)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $213.80 | $1,949.84 | $2,754.23 | |
Cigna
| Professional | $173.78 | $1,698.24 | $4,365.16 | |
United
| Professional | $234.42 | $1,949.84 | $5,011.87 |