| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,570.40 | $5,370.32 | $10,715.19 | |
AmeriHealth
| Facility | $4,466.84 | $4,466.84 | $4,466.84 | |
United
| Facility | $1,412.54 | $2,884.03 | $7,762.47 |
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 | $2,570.40 | $5,370.32 | $10,715.19 | |
AmeriHealth
| Facility | $4,466.84 | $4,466.84 | $4,466.84 | |
United
| Facility | $1,412.54 | $2,884.03 | $7,762.47 |