| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,000.00 | $7,413.10 | $9,772.37 | |
Medcost
| Facility | $190.55 | $645.65 | $1,819.70 | |
United
| Facility | $380.19 | $1,202.26 | $3,548.13 |
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 | $1,000.00 | $7,413.10 | $9,772.37 | |
Medcost
| Facility | $190.55 | $645.65 | $1,819.70 | |
United
| Facility | $380.19 | $1,202.26 | $3,548.13 |