| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $12,302.69 | $12,302.69 | $12,302.69 | |
Martin's Point
| Facility | $12,302.69 | $12,302.69 | $12,302.69 |
Laparoscopy, surgical; ureteroneocystostomy with cystoscopy and ureteral stent placement
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $12,302.69 | $12,302.69 | $12,302.69 | |
Martin's Point
| Facility | $12,302.69 | $12,302.69 | $12,302.69 |