| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,235.94 | $3,235.94 | $7,244.36 | |
United
| Facility | $100.00 | $100.00 | $100.00 |
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 | $3,235.94 | $3,235.94 | $7,244.36 | |
United
| Facility | $100.00 | $100.00 | $100.00 |