| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $419.12 | $2,080.00 | $4,100.00 | |
Kaiser Permanente
| Professional | $401.88 | $883.25 | $883.25 | |
United
| Facility | $1,832.00 | $2,343.00 | $26,408.00 |
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 | $419.12 | $2,080.00 | $4,100.00 | |
Kaiser Permanente
| Professional | $401.88 | $883.25 | $883.25 | |
United
| Facility | $1,832.00 | $2,343.00 | $26,408.00 |