| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,023.00 | $3,498.00 | $10,439.00 | |
Medica
| Facility | $357.24 | $600.33 | $5,565.00 | |
United
| Facility | $1,436.00 | $3,096.00 | $5,565.00 |
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 | $1,023.00 | $3,498.00 | $10,439.00 | |
Medica
| Facility | $357.24 | $600.33 | $5,565.00 | |
United
| Facility | $1,436.00 | $3,096.00 | $5,565.00 |