| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $977.24 | $2,754.23 | $4,073.80 | |
Kaiser Permanente
| Professional | $870.96 | $912.01 | $2,041.74 | |
United
| Facility | $165.96 | $549.54 | $5,888.44 |
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 | $977.24 | $2,754.23 | $4,073.80 | |
Kaiser Permanente
| Professional | $870.96 | $912.01 | $2,041.74 | |
United
| Facility | $165.96 | $549.54 | $5,888.44 |