| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,389.63 | $1,389.63 | $9,500.00 | |
Medica
| Facility | $1,389.63 | $1,929.32 | $5,918.84 |
Laparoscopy, surgical; ureteroneocystostomy with cystoscopy and ureteral stent placement
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,389.63 | $1,389.63 | $9,500.00 | |
Medica
| Facility | $1,389.63 | $1,929.32 | $5,918.84 |