| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $169.82 | $758.58 | $1,412.54 | |
CareSource
| Facility | $190.55 | $190.55 | $229.09 | |
Cigna
| Facility | $34.67 | $302.00 | $302.00 | |
United
| Facility | $457.09 | $457.09 | $457.09 |
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 | $169.82 | $758.58 | $1,412.54 | |
CareSource
| Facility | $190.55 | $190.55 | $229.09 | |
Cigna
| Facility | $34.67 | $302.00 | $302.00 | |
United
| Facility | $457.09 | $457.09 | $457.09 |