| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,192.40 | $1,192.40 | $8,500.00 | |
Medica
| Facility | $1,192.40 | $1,606.10 | $3,577.20 |
Ureterolysis, with or without repositioning of ureter for retroperitoneal fibrosis
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,192.40 | $1,192.40 | $8,500.00 | |
Medica
| Facility | $1,192.40 | $1,606.10 | $3,577.20 |