| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $760.00 | $2,876.00 | $7,500.00 | |
Medica
| Facility | $184.73 | $841.60 | $1,883.00 | |
United
| Facility | $100.00 | $610.00 | $1,883.00 |
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 | $760.00 | $2,876.00 | $7,500.00 | |
Medica
| Facility | $184.73 | $841.60 | $1,883.00 | |
United
| Facility | $100.00 | $610.00 | $1,883.00 |