| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,691.53 | $5,495.41 | $10,715.19 | |
Horizon BCBS
| Facility | $7,244.36 | $11,220.18 | $17,378.01 | |
United
| Facility | $1,862.09 | $3,801.89 | $7,943.28 |
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 | $2,691.53 | $5,495.41 | $10,715.19 | |
Horizon BCBS
| Facility | $7,244.36 | $11,220.18 | $17,378.01 | |
United
| Facility | $1,862.09 | $3,801.89 | $7,943.28 |