| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,099.02 | $6,541.00 | $13,413.92 | |
Moda Health
| Facility | $385.98 | $1,738.09 | $2,433.33 | |
Providence
| Facility | $385.98 | $1,738.09 | $2,433.33 |
Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service;
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,099.02 | $6,541.00 | $13,413.92 | |
Moda Health
| Facility | $385.98 | $1,738.09 | $2,433.33 | |
Providence
| Facility | $385.98 | $1,738.09 | $2,433.33 |