| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $306.58 | $379.13 | $8,500.00 | |
Medica
| Facility | $306.58 | $424.89 | $919.77 |
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 | $306.58 | $379.13 | $8,500.00 | |
Medica
| Facility | $306.58 | $424.89 | $919.77 |