| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,735.01 | $3,735.01 | $3,735.01 | |
Martin's Point
| Facility | $3,735.01 | $3,735.01 | $3,735.01 |
Ureteral Endoscopy Via Ureterostomy
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,735.01 | $3,735.01 | $3,735.01 | |
Martin's Point
| Facility | $3,735.01 | $3,735.01 | $3,735.01 |