| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,246.57 | $6,541.00 | $13,413.92 | |
Moda Health
| Facility | $230.31 | $1,212.18 | $4,974.13 | |
Providence
| Facility | $230.31 | $1,212.18 | $4,974.13 |
Balloon dilation, ureteral stricture, 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
| Facility | $2,246.57 | $6,541.00 | $13,413.92 | |
Moda Health
| Facility | $230.31 | $1,212.18 | $4,974.13 | |
Providence
| Facility | $230.31 | $1,212.18 | $4,974.13 |