| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,165.26 | $6,541.00 | $13,413.92 | |
Moda Health
| Facility | $411.59 | $1,842.86 | $2,580.00 | |
Providence
| Facility | $411.59 | $1,842.86 | $2,580.00 |
Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilation of ureter
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,165.26 | $6,541.00 | $13,413.92 | |
Moda Health
| Facility | $411.59 | $1,842.86 | $2,580.00 | |
Providence
| Facility | $411.59 | $1,842.86 | $2,580.00 |