| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $235.87 | $703.52 | $1,222.77 | |
Martin's Point
| Facility | $703.52 | $703.52 | $703.52 |
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 | $235.87 | $703.52 | $1,222.77 | |
Martin's Point
| Facility | $703.52 | $703.52 | $703.52 |