| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $988.00 | $2,898.00 | $3,444.00 | |
Kaiser Permanente
| Professional | $187.97 | $954.11 | $1,214.32 | |
United
| Facility | $1,078.00 | $1,078.00 | $1,078.00 |
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 | $988.00 | $2,898.00 | $3,444.00 | |
Kaiser Permanente
| Professional | $187.97 | $954.11 | $1,214.32 | |
United
| Facility | $1,078.00 | $1,078.00 | $1,078.00 |