| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $696.07 | $4,450.00 | $8,031.00 | |
Anthem BCBS
| Facility | $2,826.00 | $4,451.02 | $11,936.00 | |
United
| Facility | $4,565.00 | $7,010.00 | $11,152.00 |
Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $696.07 | $4,450.00 | $8,031.00 | |
Anthem BCBS
| Facility | $2,826.00 | $4,451.02 | $11,936.00 | |
United
| Facility | $4,565.00 | $7,010.00 | $11,152.00 |